Individual
JACQUELINE HICKS-PROPHET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
207 HIGHGATE AVE, BUFFALO, NY 14215-1023
(716) 833-6615
Mailing address
207 HIGHGATE AVE, BUFFALO, NY 14215
(716) 833-6615
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
369850
NY
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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