Provider Demographics
NPI:1699381749
Name:AMICK, KARRIE JO
Entity Type:Individual
Prefix:
First Name:KARRIE
Middle Name:JO
Last Name:AMICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651-1805
Mailing Address - Country:US
Mailing Address - Phone:304-872-1162
Mailing Address - Fax:
Practice Address - Street 1:1205 BROAD ST
Practice Address - Street 2:
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651-1805
Practice Address - Country:US
Practice Address - Phone:304-872-1162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker