Provider Demographics
NPI:1255098026
Name:AMICK, KARLI (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KARLI
Middle Name:
Last Name:AMICK
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W KUMLER ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:OH
Mailing Address - Zip Code:43105-1117
Mailing Address - Country:US
Mailing Address - Phone:740-438-2053
Mailing Address - Fax:
Practice Address - Street 1:1375 CHERRY WAY DR STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-8700
Practice Address - Country:US
Practice Address - Phone:614-383-7199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028241363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherDO NOT WANT TO ASSOCIATE OTHER PROVIDERS