Individual
MS. LAURA LYTTON HICKMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1247 NE MEDICAL CENTER DR, SUITE C, BEND, OR 97701-3786
(541) 318-4249
(541) 388-3832
Mailing address
19527 HOLLYGRAPE ST, BEND, OR 97702-2914
(541) 389-9284
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
080046486N7
OR
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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