| NPI | 1972198802 |
|---|---|
| Former Name | MARISSA A HICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11011915) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11011915) |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2022-12-21 |