Individual
WANDA F HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1308 WEST 5TH AVE, CROSSETT, AR 71635
(870) 364-6471
(870) 364-9753
Mailing address
1308 W 5TH AVE, CROSSETT, AR 71635-2500
(870) 364-6471
(870) 364-9753
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L28915
AR
Other
Enumeration date
08/14/2008
Last updated
02/05/2009
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