Provider Demographics
NPI:1659125466
Name:GICK, ERIC PAUL (RN)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:PAUL
Last Name:GICK
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 GOLDEN ARM RD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-8606
Mailing Address - Country:US
Mailing Address - Phone:386-956-9308
Mailing Address - Fax:407-548-1467
Practice Address - Street 1:525 GOLDEN ARM RD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-8606
Practice Address - Country:US
Practice Address - Phone:386-956-9308
Practice Address - Fax:407-548-1467
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3321752163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse