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Organization

MILESTONES PEDIATRIC CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ASHLEY HATCHER HICKMAN CPNP (OWNER)
(601) 990-4028
Entity
Organization

Contact information

Practice address
224 S CHURCH ST STE B, BROOKHAVEN, MS 39601-3232
(601) 990-4028
Mailing address
224 S CHURCH ST STE B, BROOKHAVEN, MS 39601-3232
(601) 990-4028

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008700082
MS
Enumeration date
06/17/2020
Last updated
01/19/2023
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