Provider Demographics
NPI:1043821879
Name:HICKS, DEVYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEVYN
Middle Name:
Last Name:HICKS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-2458
Mailing Address - Country:US
Mailing Address - Phone:501-941-3131
Mailing Address - Fax:501-941-3137
Practice Address - Street 1:1325 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-2458
Practice Address - Country:US
Practice Address - Phone:501-941-3131
Practice Address - Fax:501-941-3137
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD14152183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist