Latham-Hickman, Jennivie Shaunette

Latham-Hickman, Jennivie Shaunette is an individual health care provider with primary practice located at 101 Westover Cir Suite A, Madison AL 35758-4900. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Latham-Hickman, Jennivie Shaunette can be contacted via phone (256) 461-0209.

Contact Information

Primary practice address
101 Westover Cir Suite A Madison AL 35758-4900
Phone: (256) 461-0209
Fax: (256) 325-3147
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1-098043 Alabama

Profile Details

NPI number 1962747071
LBN Legal business name Latham-Hickman, Jennivie Shaunette
Credentials FAMILY NP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2012
Last updated Jan 9th, 2024 - about 8 months 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 1962747071 NPPES
Alabama MEDICAID 148215

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