Teresa Anne Hicks, RD

Individual provider Active NPI Registered Dietitian · Anchorage, AK

NPI 1497783302 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1497783302
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
95 (AK)
Practice address
4315 Diplomacy Dr
Attn: Sherry Reedy
Anchorage, AK 99508-5926
Phone
(907) 729-3971
Fax
(907) 729-1542
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
95AKMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 95 AK Yes

Addresses

Primary practice location

4315 Diplomacy Dr
Attn: Sherry Reedy
Anchorage, AK 99508-5926

Mailing address

4315 Diplomacy Dr
Attn: Sherry Reedy
Anchorage, AK 99508-5926
Phone (907) 729-3971

Other identifiers

IdentifierTypeStateIssuer
DT0095MedicaidAK

Other providers in Anchorage, AK

All providers in Anchorage, AK · Registered Dietitian in Alaska

Sources for this page

Verify at the official NPI Registry.