Hicks, Larissa Jean

Hicks, Larissa Jean is an sole proprietor health care provider with primary practice located at 1007 Maple St , Piqua OH 45356-1639. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Licensed Practical Nurse, Nursing Service Providers / Licensed Vocational Nurse. Nursing Service Providers / Licensed Practical Nurse is her primary health care specialty. Hicks, Larissa Jean can be contacted via phone (937) 541-9616.

Contact Information

Primary practice address
1007 Maple St Piqua OH 45356-1639
Phone: (937) 541-9616
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X PN116195 Ohio
Nursing Service Providers / Licensed Vocational Nurse 164X00000X PN116195 Ohio

Profile Details

NPI number 1558694240
LBN Legal business name Hicks, Larissa Jean
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 11th, 2009
Last updated May 20th, 2016 - about 8 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 1558694240 NPPES
Ohio MEDICAID 2973206

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