Provider Demographics
NPI:1417705468
Name:HICKS, SHARI (RN)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:HICKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 GLEN ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:SEVEN VALLEYS
Mailing Address - State:PA
Mailing Address - Zip Code:17360-8985
Mailing Address - Country:US
Mailing Address - Phone:410-710-5990
Mailing Address - Fax:
Practice Address - Street 1:631 GLEN ARBOR CT
Practice Address - Street 2:
Practice Address - City:SEVEN VALLEYS
Practice Address - State:PA
Practice Address - Zip Code:17360-8985
Practice Address - Country:US
Practice Address - Phone:410-710-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN710678163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse