Provider Demographics
NPI:1164854584
Name:SICKLER, KARAH KILEY-RAE (AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KARAH
Middle Name:KILEY-RAE
Last Name:SICKLER
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:MRS
Other - First Name:KARAH
Other - Middle Name:KILEY-RAE
Other - Last Name:CRIPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP-BC
Mailing Address - Street 1:2601 NW 23RD BLVD
Mailing Address - Street 2:APT 204
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-5905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 NW 23RD BLVD
Practice Address - Street 2:APT 204
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-5905
Practice Address - Country:US
Practice Address - Phone:352-214-7238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2017-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9273396363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010166700Medicaid
FL010166700Medicaid