Individual
ALISHA NICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 364-1309
Mailing address
2514 CONCORD BLVD, BRANDON, MS 39047-8537
(901) 871-2526
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-16609
MS
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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