Dr TIA M GULLICKSON is a female medical professional, specializing in Nurse Practitioner. She graduated in 2015.
RIVERVIEW HEALTHCARE ASSOCIATION
105 INTERNATIONAL DR
RED LAKE FALLS
MN
567504665
Tel: 2182534606
| Npi | 1992187868 |
| Pac Id | 0749593804 |
| Professional Enrollment Id | I20150717001787 |
| Last Name | GULLICKSON |
| First Name | TIA |
| Middle Name | M |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
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| Organization Legal Name | RIVERVIEW HEALTHCARE ASSOCIATION |
| Group Practice Pac Id | 7810806718 |
| Number Of Group Practice Members | 35 |
| Line 1 Street Address | 105 INTERNATIONAL DR |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | RED LAKE FALLS |
| State | MN |
| Zip Code | 567504665 |
| Phone Number | 2182534606 |
| Hospital Affiliation Ccn 1 | 241320 |
| Hospital Affiliation Lbn 1 | RIVERVIEW HOSPITAL |
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| Professional Accepts Medicare Assignment | Y |
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