Most Relevant Information
Provider Data
| NPI Number: | 1003382516 |
| Provider Name: | MISTI DAWN ICKES CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | RN556888 |
Most Important Dates
| Enumeration Date: | 10/23/2018 |
| Last Updated: | 10/23/2018 |
Provider Practice Location
600 CLEMENTS BRIDGE RD
BARRINGTON
NJ
080071814
Practice Location Phone/Fax
| Phone: | 8565478000 |
| Fax: |
Provider Mailing Location
600 CLEMENTS BRIDGE RD
BARRINGTON
NJ
080071814
Provider Mailing Phone/Fax
| Phone: | 8565478000 |
| Fax: | 8565471008 |