Provider Demographics
NPI:1306609383
Name:SHICK, LOURDES MARIA (NP)
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:MARIA
Last Name:SHICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4080 BARTON PARK PL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-8400
Mailing Address - Country:US
Mailing Address - Phone:919-521-3853
Mailing Address - Fax:
Practice Address - Street 1:4080 BARTON PARK PL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-8400
Practice Address - Country:US
Practice Address - Phone:919-521-3853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC267606163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine