Provider Demographics
NPI:1457885543
Name:HICKS, TIFFANI S (APRN)
Entity type:Individual
Prefix:MRS
First Name:TIFFANI
Middle Name:S
Last Name:HICKS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:918-499-4855
Mailing Address - Fax:918-488-6098
Practice Address - Street 1:6465 S YALE AVE STE 202
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7804
Practice Address - Country:US
Practice Address - Phone:918-502-2280
Practice Address - Fax:918-502-2285
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKR0102802363LP0200X
OK102802363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics