Individual
MRS. LYDIA ELLEN HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
214 W. LONGVIEW DRIVE, PORTLAND, TN 37148
(615) 325-5237
Mailing address
1443 WINDING WAY DRIVE, WHITE HOUSE, TN 37188
(615) 275-5214
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN0000183239
TN
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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