Lickteig, Jennifer
Lickteig, Jennifer is an individual health care provider with primary practice located at 788 8Th Ave Se , Cedar Rapids IA 52401-2119. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Lickteig, Jennifer can be contacted via phone (319) 362-1551.Contact Information
Primary practice address
788 8Th Ave Se
Cedar Rapids IA 52401-2119
Phone: (319) 362-1551
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 34237 | Iowa |
Profile Details
| NPI number | 1801856091 |
|---|---|
| LBN Legal business name | Lickteig, Jennifer |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Oct 25th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801856091 | NPPES |
| Iowa | MEDICAID | 4213900 |
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