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General NPI Number Information
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NPI Number | 1417836594
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Entity Type | Individual
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Provider Name | TARYN HICKS RN
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Gender | Female
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 1650 BRAGAW ST
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City | ANCHORAGE
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State | AK
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Zip | 99508-3435
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Country | US
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Telephone | 907-795-6966
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Fax |
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Provider Business Mailing Address
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Address Line | 17537 TEKLANIKA DR
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City | EAGLE RIVER
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State | AK
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Zip | 99577-8129
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Country | US
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Telephone | 907-795-6966
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Fax |
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 230653
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License Number State | AK
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