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Individual

MRS. JAMIE LEANNE BALDY HICKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
619 19TH ST S, BIRMINGHAM, AL 35233-1900
(205) 975-3107
Mailing address
300 DEBRA AVE, CLANTON, AL 35045-2009
(256) 566-6911

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1-074196
AL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
ARNP 9315696
FL

Other

Enumeration date
05/17/2011
Last updated
07/11/2012
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