Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 17287 | NE |
NPI | 1144327966 |
---|---|
Provider Name | Nancy T Hicks |
First Address | Omaha, NE 68124-3038 |
Second Address | Omaha, NE 68124-3038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E28781 | (02) | NE |