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NPI Code Detail

MEDICARE: ERIC KLICK AGACNP

MEDICARE: ERIC KLICK AGACNP
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
1390200000XStudent in an Organized Health Care Education/Training ProgramMO

General Provider Information

NPI Number : 1952264566
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC KLICK AGACNP
Provider Business Mailing Address
First Line : 1600 PRAISE BLVD
Second Line :
City : FENTON
State : MO
Zip : 63026-2651
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 615 S NEW BALLAS RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63141-8221
Country : US
Telephone Number : 314-251-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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