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General NPI Number Information
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NPI Number | 1184012353
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Entity Type | Organization
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Legal Business Name | HEALTHCARE OF HICKORY PLLC
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 1985 TATE BLVD SE SUITE 757
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City | HICKORY
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State | NC
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Zip | 28602-1469
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Country | US
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Telephone | 828-320-0733
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Fax | 828-322-3316
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Provider Business Mailing Address
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Address Line | 1985 TATE BLVD SE SUITE 757
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City | HICKORY
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State | NC
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Zip | 28602-1469
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Country | US
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Telephone | 828-320-0733
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Fax | 828-322-3316
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN ADONIKA TROUTMAN
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Credential | NP
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Telephone | 828-320-0733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5001107
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License Number State | NC
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