IndividualActive
Lacy Hicks, CPNP
NPI 1396465621 · Pediatric Cardiology Physician · Johnson City, TN
Provider details
- NPI number
- 1396465621
- Entity type
- Individual
- Primary specialty
- Pediatric Cardiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- CPNP
- Sex
- Female
- Sole proprietor
- Yes
- License
- 1841362555 (TN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2312 Knob Creek Rd Ste 208
Johnson City, TN 37604-2367
Phone: (423) 610-1099
Fax: (423) 246-4300
Approximate (ZIP-level) locationGet directions
Mailing address
2312 Knob Creek Rd Ste 208
Johnson City, TN 37604-2367
Registry dates
- Enumerated
- 2022-08-29
- Last updated
- 2023-09-04
- Certified
- 2023-09-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.