Provider Demographics
NPI:1508694068
Name:HYDOCK, FELICIA LYNN (FNP)
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:LYNN
Last Name:HYDOCK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:FELICIA
Other - Middle Name:LYNN
Other - Last Name:SOLOVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:73 LAFLIN RD
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-7248
Mailing Address - Country:US
Mailing Address - Phone:570-855-5328
Mailing Address - Fax:
Practice Address - Street 1:176 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18708-1121
Practice Address - Country:US
Practice Address - Phone:570-675-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028864363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily