Provider Demographics
NPI:1902594393
Name:HICKORY HEALTH AND WELLNESS, LLC
Entity Type:Organization
Organization Name:HICKORY HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:STROTHER
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:615-417-8718
Mailing Address - Street 1:5364 LICKTON PIKE
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-9130
Mailing Address - Country:US
Mailing Address - Phone:615-417-8718
Mailing Address - Fax:
Practice Address - Street 1:4003 MURPHY RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-4910
Practice Address - Country:US
Practice Address - Phone:615-925-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty