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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801856091 NPPES
Iowa MEDICAID 4213900

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