Provider Demographics
NPI:1427571389
Name:HICKS, SONYA K (NP)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:K
Last Name:HICKS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1705 MAIN AVE SW STE B
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-7207
Mailing Address - Country:US
Mailing Address - Phone:256-739-0455
Mailing Address - Fax:256-739-2706
Practice Address - Street 1:1705 MAIN AVE SW STE B
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-7207
Practice Address - Country:US
Practice Address - Phone:256-739-0455
Practice Address - Fax:256-739-2706
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL2017003746363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology