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Individual

TRACEY QUAY HICKMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP, APMHNP

Contact information

Practice address
601 FOOTE ST, CORINTH, MS 38834-4834
(662) 287-4424
Mailing address
601 FOOTE ST, CORINTH, MS 38834-4834
(662) 287-4424

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R782227
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R782227
MS

Other

Enumeration date
10/04/2009
Last updated
02/29/2016
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