Individual
LATRINDA JENIECE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N EASTMAN RD APT 1141, LONGVIEW, TX 75605-4067
(903) 315-9133
Mailing address
2500 N EASTMAN RD APT 1141, LONGVIEW, TX 75605-4067
(903) 315-9133
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
343060
TX
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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