National Provider Identifier Database

JEREMY FICKEN, NP-C – NPI #1699164202
Family


Contact Information

JEREMY FICKEN, NP-C
750 N ESTRELLA PKWY
STE 40
GOODYEAR, AZ85338-9272
Phone: 623-889-3477
Fax: 623-889-3478
Website:
Specialty Taxonomy Code
* Family 363LF0000X
Ambulatory Family Planning Facility 261QA0005X

* Indicates primary specialty

NPI Profile & details for JEREMY FICKEN

NPI Number 1699164202
Credentials NP-C (Nurse Practitioner - Certified)
Entity Individual
Enumeration date 01/20/2015
Last updated 04/07/2015 - About 11 years ago
Sole proprietor1 Yes
Identifiers
  • AZ License #: 147824
  • CA License #: 583861
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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