Individual
CONNIE FAIRLEY HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP-NP
Contact information
Practice address
3801 LAKE BOONE TRL, SUITE G, RALEIGH, NC 27607-2934
(919) 865-8710
(919) 256-0772
Mailing address
3801 LAKE BOONE TRL, RALEIGH, NC 27607-2934
(919) 856-8710
(919) 256-0772
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5004262
NC
Other
Enumeration date
01/23/2009
Last updated
11/30/2012
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