NPI 1003174533

Leeann Wickens, PA

Practitioner Physician Assistant Clinton Twp, MI

Practice location

Address: 15855 19 Mile Rd, Clinton Twp, MI 48038-3504
Phone: (586) 203-1940

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 5601001022 (MI)

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Registry record

NPI: 1003174533
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 May 2012
Record last updated: 10 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.