Provider Demographics
NPI:1750124483
Name:NURSE THICKS DOT SOLUTIONS LLC
Entity type:Organization
Organization Name:NURSE THICKS DOT SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TENNILLE
Authorized Official - Middle Name:MORRIS
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:678-789-0762
Mailing Address - Street 1:179 COOK DR
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-2617
Mailing Address - Country:US
Mailing Address - Phone:678-789-0762
Mailing Address - Fax:404-500-0925
Practice Address - Street 1:1397 CEDAR GROVE RD STE 14
Practice Address - Street 2:
Practice Address - City:CONLEY
Practice Address - State:GA
Practice Address - Zip Code:30288-1107
Practice Address - Country:US
Practice Address - Phone:478-220-0040
Practice Address - Fax:404-500-0925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-19
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No332900000XSuppliersNon-Pharmacy Dispensing Site