Individual
DIANA HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
876 N VAN DYKE RD, BAD AXE, MI 48413-9016
(989) 623-0137
(989) 921-4977
Mailing address
501 LAPEER AVE, SAGINAW, MI 48607-1203
(989) 759-6464
(989) 399-8233
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704304099
MI
363LF0000X
Family Nurse Practitioner
Primary
4704304099
MI
Other
Enumeration date
08/29/2019
Last updated
04/08/2021
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