Hicks, Lisa A

Hicks, Lisa A is an individual health care provider with primary practice located at 17177 N Laurel Park Dr Ste 417 , Livonia MI 48152-3952. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Hicks, Lisa A can be contacted via phone (888) 414-7056.

Contact Information

Primary practice address
17177 N Laurel Park Dr Ste 417 Livonia MI 48152-3952
Phone: (888) 414-7056
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 4703120442 Michigan

Profile Details

NPI number 1154961209
LBN Legal business name Hicks, Lisa A
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 7th, 2020
Last updated Jan 7th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154961209 NPPES
Michigan MEDICAID O435522029817

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