Wickliffe, Debra
Wickliffe, Debra is an sole proprietor health care provider with primary practice located at 134 Nw Olive Gln , Lake City FL 32055-9210. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Wickliffe, Debra can be contacted via phone (386) 965-2770.Contact Information
Primary practice address
134 Nw Olive Gln
Lake City FL 32055-9210
Phone: (386) 965-2770
Fax: (386) 754-2770
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Contractor | 171W00000X | 6908802996 | Florida |
Profile Details
| NPI number | 1821285446 |
|---|---|
| LBN Legal business name | Wickliffe, Debra |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2007 |
| Last updated | Sep 27th, 2007 - about 18 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 | 1821285446 | NPPES |
| Florida | MEDICAID | 6908802965 |
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