Provider Demographics
NPI:1184012353
Name:HEALTHCARE OF HICKORY PLLC
Entity Type:Organization
Organization Name:HEALTHCARE OF HICKORY PLLC
Other - Org Name:HEALTHCARE OF HICKORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ADONIKA
Authorized Official - Last Name:TROUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:828-320-0733
Mailing Address - Street 1:1985 TATE BLVD SE
Mailing Address - Street 2:SUITE 757
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1469
Mailing Address - Country:US
Mailing Address - Phone:828-320-0733
Mailing Address - Fax:828-322-3316
Practice Address - Street 1:1985 TATE BLVD SE
Practice Address - Street 2:SUITE 757
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1469
Practice Address - Country:US
Practice Address - Phone:828-320-0733
Practice Address - Fax:828-322-3316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5001107363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty