| NPI | 1306358171 |
|---|---|
| Former Name | TIFFANY MICHELLE HICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: WA AP61309304) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: MO 2014042988) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2022-08-08 |