Individual
MS. SALLY ANN WILLIAMS HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CS-FNP
Contact information
Practice address
1100 N KENTUCKY AVE, WEST PLAINS, MO 65775-2029
(417) 256-9111
(417) 255-9732
Mailing address
1100 KENTUCKY AENUE, WEST PLAINS, MO 65775
(417) 256-9111
(417) 255-9732
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2004029904
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427376405
—
MO
05
—
599022307
—
MO
05
—
599022308
—
MO
Enumeration date
05/20/2006
Last updated
02/26/2016
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