Individual
MRS. ANNA MARIA HICKOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
258 CHAMPION ST, BUILDING 500, CARTHAGE, NY 13619-3361
(315) 408-2869
Mailing address
4814 TEXAS RD, CARTHAGE, NY 13619-6056
(315) 493-0558
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
277484-1
NY
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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