Hicks, Lacy
Hicks, Lacy is an sole proprietor health care provider with primary practice located at 2312 Knob Creek Rd Ste 208 , Johnson City TN 37604-2367. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as her primary health care specialty. Hicks, Lacy can be contacted via phone (423) 610-1099.Contact Information
Primary practice address
2312 Knob Creek Rd Ste 208
Johnson City TN 37604-2367
Phone: (423) 610-1099
Fax: (423) 246-4300
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Cardiology | 2080P0202X | 1841362555 | Tennessee |
Profile Details
| NPI number | 1396465621 |
|---|---|
| LBN Legal business name | Hicks, Lacy |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 29th, 2022 |
| Last updated | Sep 4th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396465621 | NPPES |
| Other | 1376533489 | NPI | |
| Other | 1578856985 | NPI |
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