Healthcare Provider Details

I. General information

NPI: 1164576021
Provider Name (Legal Business Name): CHERRI ALLISON HICKS MSN, APRN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7703 FLOYD CURL
SAN ANTONIO TX
78216
US

IV. Provider business mailing address

14 SILVERHORN DR
SAN ANTONIO TX
78216-7883
US

V. Phone/Fax

Practice location:
  • Phone: 210-567-3843
  • Fax:
Mailing address:
  • Phone: 210-545-1984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number253623
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: