IndividualActive
Amanda Wicker, LPN
NPI 1265637987 · Licensed Practical Nurse · East Prairie, MO
Provider details
- NPI number
- 1265637987
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- No
- License
- 2003028629 (MO)
Specialties & taxonomies
Nursing Service Providers
Practice location
106 S Washington St
East Prairie, MO 63845-1526
Phone: (573) 649-9411
Fax: (573) 649-9442
Approximate (ZIP-level) locationGet directions
Mailing address
106 S Washington St
East Prairie, MO 63845-1526
Registry dates
- Enumerated
- 2007-06-21
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.