person
Holly Hicks-deridder, PA-C
Medical Physician Assistant in Newnan, Georgia
NPI 1578641627

Holly Hicks-deridder is a Medical Physician Assistant based in Newnan, GA and is specialized in Medical. Holly Hicks-deridder practices in Newnan, GA and has the professional credentials of PA-C. The NPI Number for Holly Hicks-deridder is 1578641627 and holds a License No. 003338 (Georgia).

The current practice location address for Holly Hicks-deridder is 2700 Highway 34 E Bldg 300, Newnan, GA and can be reached out via phone at 770-304-0987 and via fax at 770-251-0938. You can also correspond with Holly Hicks-deridder through the mailing address at 2700 HIGHWAY 34 E BLDG 300, NEWNAN, GA - 30265-1330 (mailing address contact number: 770-304-0987).

Location: 2700 Highway 34 E Bldg 300, Newnan, GA, 30265-1330
person
Provider Profile Details
NPI Number
1578641627
Provider Name
Holly Hicks-deridder
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
2700 Highway 34 E Bldg 300, Newnan, GA, 30265-1330
Phone Number
770-304-0987
Fax Number
770-251-0938
Provider Enumeration Date
11/02/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100002196A 05 GA
institution
Provider Business Practice Location Address Details
Address
2700 Highway 34 E Bldg 300
City
State
Zip
30265-1330
Phone Number
770-304-0987
Fax Number
770-251-0938
person
Provider Business Mailing Address Details
Address
2700 Highway 34 E Bldg 300
City
State
Zip
30265-1330
Phone Number
770-304-0987
Fax Number
770-251-0938
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
003338 (Georgia)
Definition
Definition to come...
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