Individual
JAZZ LESOLEIL HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP, CNM
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
104674984
MA
367A00000X
Advanced Practice Midwife
Primary
RN2309018
MA
Other
Enumeration date
07/17/2020
Last updated
11/27/2024
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