NPI Profile for JEREMY FICKEN in GOODYEAR, AZ.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Ambulatory Family Planning Facility |
261QA0005X |
| NPI Number | 1699164202 |
|
| Status | Active | |
| Credentials | NP-C (Nurse Practitioner - Certified) | |
| Entity | Individual | |
| Enumeration date | 01/20/2015 | |
| Last updated | 04/07/2015 - About 11 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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