MEDICARE: KAITLYN RENEE FICKLIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		IN

General Provider Information

NPI Number	:	1255262606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN RENEE FICKLIN

Provider Business Mailing Address
First Line	:	2443 WINDEMERE DR
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47725-6567
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7313 EAGLE CREST BLVD
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-8157
Country	:	US
Telephone Number	:	812-737-3931
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ KAITLYN RENEE FICKLIN ” Practice Location

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