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Individual

MRS. DEBORAH LEE HICKETHIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
25977 205TH AVE, CORNELL, WI 54732-5536
(715) 239-6332
Mailing address
25977 205TH AVE, CORNELL, WI 54732-5536
(715) 239-6332

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
193766-30
WI
163WH0200X
Home Health Registered Nurse
193766-30
WI

Other

Enumeration date
07/09/2014
Last updated
07/09/2014
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