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Individual
PIKE PICKETT
Active
Individual
PIKE PICKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN117053
LA
363L00000X
Nurse Practitioner
AP06612
LA
363LF0000X
Family Nurse Practitioner
Primary
1075931
TX
Other
Enumeration date
03/24/2011
Last updated
04/19/2024
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