Provider Demographics
NPI:1962973883
Name:HICKS, HAILEY ELIZABETH (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:HAILEY
Middle Name:ELIZABETH
Last Name:HICKS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 GRAHAM DR STE 200
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-3346
Mailing Address - Country:US
Mailing Address - Phone:281-255-3838
Mailing Address - Fax:832-698-4231
Practice Address - Street 1:506 GRAHAM DR STE 200
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-3346
Practice Address - Country:US
Practice Address - Phone:281-255-3838
Practice Address - Fax:832-698-4231
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138160363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP138160OtherSTATE OF TEXAS BOARD OF NURSING