Individual
MRS. HENRIETTA HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN.
Contact information
Practice address
50 DUPONT HARTSCHAPEL RD., POPLARVILLE, MS 39470-4231
(601) 795-8732
(601) 795-8732
Mailing address
50 DUPONT HARTSCHAPEL RD., POPLARVILLE, MS 39470-4231
(601) 795-8732
(601) 795-8732
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P245887
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770165
—
MS
Enumeration date
10/18/2006
Last updated
07/09/2007
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