Provider Demographics
NPI:1124596614
Name:HICKS, STEPHANIE DARLENE (APRN AGCNS-BC CCRN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DARLENE
Last Name:HICKS
Suffix:
Gender:F
Credentials:APRN AGCNS-BC CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 MEDICAL CENTER DR STE 380
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1780
Mailing Address - Country:US
Mailing Address - Phone:972-529-6939
Mailing Address - Fax:972-529-6935
Practice Address - Street 1:4201 MEDICAL CENTER DR STE 380
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1780
Practice Address - Country:US
Practice Address - Phone:972-529-6939
Practice Address - Fax:972-529-6935
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135123364SC0200X, 364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology
No364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine