Individual
DINA HICKS HERREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1806 LEE AVE, TIFTON, GA 31794-3639
(229) 386-1528
(229) 388-0556
Mailing address
1806 LEE AVE, TIFTON, GA 31794-3639
(229) 386-1528
(229) 388-0556
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN178293
GA
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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