Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 2018010258 | MO |
Y | 111NI0900X | Internist | 2018010258 | MO |
NPI | 1003294927 |
---|---|
Provider Name | Erin Rice Fick |
First Address | Saint Louis, MO 63156-3340 |
Second Address | Hazelwood, MO 63042-1759 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2015 |
Last Update Date | 08/02/2019 |