Individual
MRS. PAMELA R HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
544 RL BOLTON RD, JASPER, TN 37347-5942
(423) 847-5453
(423) 837-8002
Mailing address
544 RL BOLTON RD, JASPER, TN 37347-5942
(423) 847-5453
(423) 837-8002
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
89766
TN
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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