Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. HOLLY D WICKENHAUSER, ATC
ActiveMS. HOLLY D WICKENHAUSER, ATC is a Athletic Trainer healthcare provider located in BLOOMINGTON, Illinois. NPI 1659546422 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · BLOOMINGTON, IL
Registration Details
- NPI Number
- 1659546422
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 23, 2008 (18.274887625719 yrs)
- Last Updated
- Jan 4, 2017
- License
-
096.001891 (IL)
Practice Information
- Address
-
1111 TRINITY LNSUITE 111BLOOMINGTON, IL, 617048111Browse IL providers · Browse ZIP 61704
- Phone
- 3096636461
- Fax
- 3096635711
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in BLOOMINGTON, IL
| Name | Credential | NPI |
|---|---|---|
| MR. JEFFREY A. BURK | — | 1972593515 |
| DR. WILLIAM ALLEN KAUTH | ED.D. , ATC, CSCS | 1154394393 |
| MRS. EMILY ANN MILLER | M.S., ATC, CSCS | 1881667632 |
| NANCY MCCRISKIN | ATC/L | 1023079357 |
| MR. JEFFREY A PROBST | ATC | 1538351366 |
| MISS AMY KATHLEEN JONES | ATC | 1043466337 |
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.