| NPI | 1417571035 |
|---|---|
| Former Name | PAIGE NICOLE KRIECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5260) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2025-07-15 |