Individual
JEANINE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7401
(701) 774-7479
Mailing address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7401
(701) 774-7479
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
849
ND
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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