Hicks, Jimmy

Hicks, Jimmy is an individual health care provider with primary practice located at 110 Hardin Ln , Somerset KY 42503-3818. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Hicks, Jimmy can be contacted via phone (606) 678-3288.

Contact Information

Primary practice address
110 Hardin Ln Somerset KY 42503-3818
Phone: (606) 678-3288
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 3360A Kentucky

Profile Details

NPI number 1871585430
LBN Legal business name Hicks, Jimmy
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Oct 22nd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871585430 NPPES
Kentucky MEDICAID 74007378

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