Individual
JOAN K HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1085 MAPLE ST, FARMINGTON, MO 63640-1955
(573) 747-2431
Mailing address
1085 MAPLE ST, FARMINGTON, MO 63640-1955
(573) 747-2431
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
028252
MO
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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