Individual
MRS. LATURE ELEASE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1100 N WOOLSEY AVE, FAYETTEVILLE, AR 72703-1847
(479) 444-7548
Mailing address
1100 N WOOLSEY AVE, FAYETTEVILLE, AR 72703-1847
(479) 444-7548
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A02945
AR
Other
Enumeration date
10/02/2006
Last updated
01/08/2014
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