IndividualActive
Jacqueline Hicks, RN
NPI 1639929417 · Addiction (Substance Use Disorder) Registered Nurse · Clarksdale, MS
Provider details
- NPI number
- 1639929417
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- License
- 883789 (MS)
Specialties & taxonomies
Nursing Service Providers
Nursing Service Providers
Practice location
448 Adams Ave
Clarksdale, MS 38614-4908
Phone: (662) 645-9705
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 755
Clarksdale, MS 38614-0755
Registry dates
- Enumerated
- 2024-03-25
- Last updated
- 2024-03-25
- Certified
- 2024-03-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.