Provider Demographics
NPI:1740159136
Name:HICKS, SHERYL VIVIAN
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:VIVIAN
Last Name:HICKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3224 CROSBY BLVD SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7820
Mailing Address - Country:US
Mailing Address - Phone:360-870-6234
Mailing Address - Fax:
Practice Address - Street 1:3224 CROSBY BLVD SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-7820
Practice Address - Country:US
Practice Address - Phone:360-870-6234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60115151163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse