Carrie Ann Licklider, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

231814 Issued in AZ

Practice address

6504 Wrenview CT
Huber Heights, OH 45424-2731

Phone

(937) 825-2127

NPI assigned

Oct 15, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: carrie@yourcarenowmobilemedical.kareodirect.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1649812231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6504 WRENVIEW CT",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454242731",
            "telephone_number": "937-825-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6504 WRENVIEW CT",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454242731",
            "telephone_number": "937-825-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICKLIDER",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "231814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "electronic",
            "affiliation": "N",
            "address_1": "6504 Wrenview Ct",
            "city": "Huber Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454242731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shelley A Lee, RMA
• Lee D Lehman, MD
• Brenda Kay Lenehan, RN
• Takeisha Rose Leroy, HHA
• Dawnyell Chnine Lewis
• Pei-Hsuan Lin, DDS
• Eva Marie Linkenbach, CNP
• Live Loved Home Care LLC
• Abby Lockhart, RBT
• Debra A Lowe, LPN

• Adult Health Nurse Practitioner in Huber Heights, OH
• Providers in Huber Heights, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.