Most Relevant Information
Provider Data
| NPI Number: | 1003232273 |
| Provider Name: | MICHELLE COLEEN HICKS FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | R175430-0 |
Most Important Dates
| Enumeration Date: | 03/12/2014 |
| Last Updated: | 04/17/2019 |
Provider Practice Location
205 WABASHA ST S
SAINT PAUL
MN
55107
Practice Location Phone/Fax
| Phone: | 6512938100 |
| Fax: | 6512938106 |
Provider Mailing Location
8170 33RD AVE S # MS 21110Q
MINNEAPOLIS
MN
554254516
Provider Mailing Phone/Fax
| Phone: | 6512938100 |
| Fax: | 9528538727 |