Individual
JENNIVIE SHAUNETTE LATHAM-HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FAMILY NP
Contact information
Practice address
6001 MARCUS BYERS DR NE, HUNTSVILLE, AL 35811-1157
(256) 864-6656
(256) 864-6657
Mailing address
6001 MARCUS BYERS DR NE, HUNTSVILLE, AL 35811-1157
(256) 864-6656
(256) 864-6657
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-098043
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148215
—
AL
Enumeration date
11/29/2012
Last updated
05/15/2025
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