Provider Demographics
NPI:1124362488
Name:HICKS, VICTOR JEROME JR (APN)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:JEROME
Last Name:HICKS
Suffix:JR
Gender:M
Credentials:APN
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Mailing Address - Street 1:1665 OLD HOT SPRINGS RD STE 157
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0663
Mailing Address - Country:US
Mailing Address - Phone:775-687-5162
Mailing Address - Fax:775-687-5975
Practice Address - Street 1:485 W B ST STE 101
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-2765
Practice Address - Country:US
Practice Address - Phone:775-423-4434
Practice Address - Fax:775-423-0422
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2021-03-01
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Provider Licenses
StateLicense IDTaxonomies
NVAPN001442363LF0000X
NVAPRN001442363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily