Individual
MICHELLE DAWN HICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
174 MURRAY GUARD DR, SUITE A, JACKSON, TN 38305-3742
(731) 660-6168
(731) 660-6296
Mailing address
110 LOMBARDY ST, TRENTON, TN 38382-3106
(731) 855-3132
(731) 855-3132
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN0000013561
TN
Other
Enumeration date
05/13/2008
Last updated
08/15/2011
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