Provider Demographics
NPI:1538431002
Name:HICKS, BRITTANY ANNE (NP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANNE
Last Name:HICKS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ANNE
Other - Last Name:MOODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 1810
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39502-1810
Mailing Address - Country:US
Mailing Address - Phone:228-575-1800
Mailing Address - Fax:228-865-3038
Practice Address - Street 1:1340 BROAD AVE STE 330
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2464
Practice Address - Country:US
Practice Address - Phone:228-575-1234
Practice Address - Fax:228-867-4828
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR882745363LF0000X
MS882745363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily