Provider Demographics
NPI:1104367465
Name:HICKS-WILLIAMS, ANYTA (AGNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANYTA
Middle Name:
Last Name:HICKS-WILLIAMS
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1132
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32591-1132
Mailing Address - Country:US
Mailing Address - Phone:850-313-4616
Mailing Address - Fax:
Practice Address - Street 1:282 N PALAFOX ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-4841
Practice Address - Country:US
Practice Address - Phone:850-313-4616
Practice Address - Fax:619-329-8933
Is Sole Proprietor?:No
Enumeration Date:2017-03-19
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006047363LA2200X, 363LG0600X
GAGAA-NP000275363LA2200X, 363LG0600X
FLAPRN11010204363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology