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Individual
PAULA ANN HICKS
Active
Individual
PAULA ANN HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
19498
NE
207W00000X
Ophthalmology Physician
Primary
3820
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003388
SD WELLMARK BLUE SHIELD
SD
01
—
22053
NE BLUE SHIELD
NE
05
—
36-3050195-13
—
SD
05
—
36-3050195-14
—
NE
01
—
3820
DAKOTACARE PROVIDER ID
SD
05
—
6300100
—
SD
01
—
NA1114001
NE MEDICARE PTAN NORFOLK, NE
NE
01
—
NA1115001
NE MEDICARE PTAN WAYNE, NE
NE
Enumeration date
05/24/2005
Last updated
11/04/2008
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