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General NPI Number Information
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NPI Number | 1972968790
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Entity Type | Individual
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Provider Name | TAMERA J HIX
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Gender | Female
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 1008 N MAIN ST
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City | SIKESTON
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State | MO
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Zip | 63801-5044
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Country | US
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Telephone | 573-471-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 601 E 14TH ST
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City | SEDALIA
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State | MO
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Zip | 65301-5972
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Country | US
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Telephone | 660-826-8833
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2016010702
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License Number State | MO
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