Individual
CHARLOTTE ELISABETH HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-5416
(704) 384-5992
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-5416
(704) 384-5992
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
101460
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8101681
—
NC
Enumeration date
03/02/2006
Last updated
11/01/2022
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