Provider Demographics
NPI:1205180585
Name:HICKS, MENDY A (NP-C)
Entity type:Individual
Prefix:MRS
First Name:MENDY
Middle Name:A
Last Name:HICKS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1272 GARRISON DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2598
Mailing Address - Country:US
Mailing Address - Phone:615-867-8010
Mailing Address - Fax:615-439-2256
Practice Address - Street 1:3325 SHORES RD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-3616
Practice Address - Country:US
Practice Address - Phone:615-867-8010
Practice Address - Fax:615-439-2256
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17178363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily