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General NPI Number Information
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NPI Number | 1912398884
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Entity Type | Individual
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Provider Name | CHRISTINE MICHELLE HICKS ANP-C
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Gender | Female
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 1380 AMERICAN WAY UNIT D
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City | BEDFORD
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State | VA
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Zip | 24523-2940
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Country | US
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Telephone | 540-583-7114
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Fax | 540-583-7112
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Provider Business Mailing Address
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Address Line | 801 YORK ST
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City | MANITOWOC
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State | WI
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Zip | 54220-4630
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Country | US
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Telephone | 920-663-9008
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Fax | 920-684-1439
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0024177743
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R130205
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License Number State | MD
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