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NPI Code Detail

MEDICARE: YVONNE M HICKS ACNP

MEDICARE: YVONNE M HICKS ACNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse PractitionerR501301MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336128248
Entity Type Code : Individual
Provider Name (Legal Business Name) : YVONNE M HICKS ACNP
Provider Business Mailing Address
First Line : 3612 GROVELAND RD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-4308
Country : US
Telephone Number : 228-818-9008
Fax Number : 228-818-0750
Provider Business Practice Location Address
First Line : 3612 GROVELAND RD.
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-4308
Country : US
Telephone Number : 228-818-9008
Fax Number : 228-818-0750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2006
Last Update Date : 07/08/2007

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