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General NPI Number Information
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NPI Number | 1124362488
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Entity Type | Individual
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Provider Name | VICTOR JEROME HICKS JR. APN
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Gender | Male
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 03/01/2021
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Provider Practice Location Address
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Address Line | 485 W B ST STE 101
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City | FALLON
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State | NV
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Zip | 89406-2765
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Country | US
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Telephone | 775-423-4434
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Fax | 775-423-0422
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Provider Business Mailing Address
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Address Line | 1665 OLD HOT SPRINGS RD STE 157
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City | CARSON CITY
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State | NV
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Zip | 89706-0663
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Country | US
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Telephone | 775-687-5162
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Fax | 775-687-5975
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN001442
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN001442
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License Number State | NV
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