NPI 1043017593
Tecilla Reshawn Hicks
Practice location
- Address
- 725 SE Baya Dr, Lake City, FL 32025-6073
- Phone
- (904) 558-1904
Registered specialties
Clinical Laboratory Director (Non-physician)
Primary
Registry record
- NPI
- 1043017593
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 3 Mar 2025
- Record last updated
- 3 Mar 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.