Individual
KESHAWN HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1124 RED WOLF LN, DACULA, GA 30019-7448
(678) 517-3521
Mailing address
1124 RED WOLF LN, DACULA, GA 30019-7448
(678) 517-3521
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
RN197191
GA
163WW0000X
Wound Care Registered Nurse
RN197191
GA
251J00000X
Nursing Care Agency
RN197191
GA
253Z00000X
In Home Supportive Care Agency
Primary
RN197191
GA
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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