Individual
DEMETRIC CHILDS-HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
228 SELMA AVE, POST OFFICE BOX 2213, SELMA, AL 36701-5825
(334) 874-7428
(334) 874-7435
Mailing address
228 SELMA AVE, P.O. BOX 2213, SELMA, AL 36701-5825
(334) 874-7428
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1-089829
AL
Other
Enumeration date
02/02/2014
Last updated
10/21/2014
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