Healthcare Provider Details

I. General information

NPI: 1710604582
Provider Name (Legal Business Name): JOANA LYNN HICKS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13830 SAWYER RANCH RD STE 102
DRIPPING SPRINGS TX
78620-5514
US

IV. Provider business mailing address

13830 SAWYER RANCH RD STE 102
DRIPPING SPRINGS TX
78620-5514
US

V. Phone/Fax

Practice location:
  • Phone: 512-301-6400
  • Fax: 512-301-6401
Mailing address:
  • Phone: 512-301-6400
  • Fax: 512-301-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1097335
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: