| Doctor Name: | LEEEVA L HICKERSON |
| NPI Number: | 1255479598 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BS |
| License Number: | |
| Business Practice Address: | 4800 Navy Rd Suite 3 Millington, TN - 380531914 |
| Business Phone Number: | 9015049915 |
| Business Fax Number: | 9015049915 |
| Mailing Address: | 4800 Navy Rd, Suite 3 MILLINGTON |
| State: | TN |
| Postal Code: | 380531914 |
| Phone Number: | 9015049915 |
| Fax Number: | 9015049915 |
| NPI Enumeration Date: | 02/01/2007 |
| NPI Last Update Date: | 01/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171W00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Contractor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |