Individual provider · Type 1 NPI
Jacqueline Hicks, RN
Addiction (Substance Use Disorder) Registered Nurse · Clarksdale, MS
NPI number
1639929417
Active
Practice location
448 Adams Ave
Clarksdale, MS 38614-4908
Mailing address
PO Box 755
Clarksdale, MS 38614-0755
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 883789 (MS) |
| Addiction (Substance Use Disorder) Registered Nurse Primary | 163WA0400X | 883789 (MS) |
Addiction (Substance Use Disorder) Registered Nurse: Definition to come...
About NPI 1639929417
Jacqueline Hicks, RN's National Provider Identifier is 1639929417, issued on Mar 25, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Registered Nurse (163WA0400X), and the practice location is in Clarksdale, MS. The record was last updated on Mar 25, 2024.