Individual
TANEKA HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 8158, STATESBORO, GA 30460-2911
(478) 262-9296
Mailing address
PO BOX 8158, STATESBORO, GA 30460-2000
(478) 262-9296
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN259146
GA
Other
Enumeration date
06/13/2025
Last updated
06/13/2025
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