Basic Information
| Provider Information | |||||||||
| NPI: | 1306024492 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HICKS | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | |||||||||
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| Credential: | R.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1615 | ||||||||
| Address2: | |||||||||
| City: | SEARCY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721451615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5017766093 | ||||||||
| FaxNumber: | 5017766019 | ||||||||
| Practice Location | |||||||||
| Address1: | 910 N EAST ST | ||||||||
| Address2: | |||||||||
| City: | BENTON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 720153327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5017780427 | ||||||||
| FaxNumber: | 5017785993 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2008 | ||||||||
| LastUpdateDate: | 06/20/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | P01008 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | P01008 | 01 | AR | REGISTERED NURSE PRACTIONER | OTHER |