Individual
MRS. TINA MARIE HICKS-GREENWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A-GNP-C
Contact information
Practice address
1075 S MAIN ST STE 400, MADISON, GA 30650-2050
(706) 818-3865
(866) 385-9163
Mailing address
1141 BRIAR LN, MADISON, GA 30650-3901
(706) 818-3865
(866) 385-9163
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN298533
GA
363LA2200X
Adult Health Nurse Practitioner
RN298533
GA
363LG0600X
Gerontology Nurse Practitioner
RN298533
GA
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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