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:
Health care specialties
| Specialty | Code | License # | 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 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 | 1962747071 | NPPES |
| Alabama | MEDICAID | 148215 |
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