ANGIE D HICKS-MASTER ANP NPI 1255405353

NPI Information

NPI: 1255405353
Provider Name: ANGIE D HICKS-MASTER, ANP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
920 EAST MEDICAL DRIVE
MANILA, AR
ZIP 72442
Phone: (810) 570-0358
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Angie D Hicks-master, ANP is a psychiatric/mental health nurse practitioner in Manila, AR with 19 years of experience. Angie D Hicks-master, ANP NPI is 1255405353. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

920 EAST MEDICAL DRIVE
MANILA, AR
ZIP 72442
Phone: (810) 570-0358
Fax: (870) 570-0359

The NPI 1255405353 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/20/2006 and was last updated on 5/28/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	A002923	ARKANSAS	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	APN0000017515	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2007012778	OTHER	MISSOURI	MO STATE LICENSE
2	17515	OTHER	TENNESSEE	TN STATE LICENSE
3	A002923	OTHER	ARKANSAS	AR STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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