Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
EMILY LOUISE WICKERSHAM, DO
ActiveEMILY LOUISE WICKERSHAM, DO is a Anatomic Pathology & Clinical Pathology healthcare provider located in BOLIVAR, Missouri. NPI 1093175358 is currently active in the NPPES registry. Verify at CMS.
Anatomic Pathology & Clinical Pathology · BOLIVAR, MO
Registration Details
- NPI Number
- 1093175358
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 29, 2016 (10.492861678657 yrs)
- Last Updated
- Jan 15, 2026
- Licenses
-
036.177695 (IL)2024028249 (MO)
Practice Information
- Address
-
1500 N OAKLAND AVEBOLIVAR, MO, 656133099Browse MO providers · Browse ZIP 65613
- Phone
- 4173266000
- Primary Specialty
-
Anatomic Pathology & Clinical Pathology
207ZP0102X
- Additional Specialty
- Anatomic Pathology & Clinical Pathology
Other Anatomic Pathology & Clinical Pathology Providers in BOLIVAR, MO
| Name | Credential | NPI |
|---|---|---|
| CHRISTINA OTTERNESS | DO | 1992091284 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.