Individual
IAN JACKSON HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1279 CATAWBA ST, KINGSPORT, TN 37660-4557
(423) 946-0279
Mailing address
1279 CATAWBA ST, KINGSPORT, TN 37660-4557
(423) 946-0279
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/13/2026
Last updated
01/14/2026
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