# ANGIE D HICKS-MASTER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1255405353
- **Gender:** F
- **Credential:** ANP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | A002923 | AR | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | APN0000017515 | TN | Yes |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 05/28/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 17515 | TN STATE LICENSE | TN |
| 01 | — | 2007012778 | MO STATE LICENSE | MO |
| 01 | — | A002923 | AR STATE LICENSE | AR |