Organization
AGRARIAN WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATIA HICKERSON PHD, MPH, APRN, WHNP (OWNER)
(832) 930-6345
Entity
Organization
Contact information
Practice address
17000 EL CAMINO REAL STE 209, HOUSTON, TX 77058
(832) 284-4328
(832) 284-4728
Mailing address
17000 EL CAMINO REAL STE 209, HOUSTON, TX 77058-2633
(832) 284-4328
(832) 284-4728
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
—
—
363LW0102X
Women's Health Nurse Practitioner
Primary
—
TX
Other
Enumeration date
11/04/2017
Last updated
06/06/2018
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