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General NPI Number Information
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NPI Number | 1669069381
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Entity Type | Individual
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Provider Name | LINDA JEAN HICKS RN,FNP
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Gender | Female
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 11/09/2023
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Provider Practice Location Address
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Address Line | 105 N CRUTCHFIELD ST # 2
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City | DOBSON
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State | NC
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Zip | 27017-8804
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Country | US
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Telephone | 888-789-2922
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Fax | 336-789-4334
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Provider Business Mailing Address
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Address Line | 105 N CRUTCHFIELD ST # 2
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City | DOBSON
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State | NC
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Zip | 27017-8804
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Country | US
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Telephone | 888-789-2922
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Fax | 336-789-4334
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5013962
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024188193
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024188193
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5013962
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 0001263586
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 201374
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License Number State | NC
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