XAQUITA WICKS (NPI# 1790214989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790214989 |
| Entity Type | Individual |
| Full Name | XAQUITA WICKS |
| Credential | MSN, BSN, RN |
| Practice Address |
1759 Broad Park Cir S Ste 113 Mansfield TX 76063-7836 |
| Practice Telephone | (817) 473-1312 |
| Mailing Telephone | 8174731312 |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2020-08-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WG0000X |
Registered Nurse Specialization: General Practice |
847794 | TX | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | NURSE LICENSE | 847794 | 01 |
| Street Address |
1759 BROAD PARK CIR S STE 113 |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063-7836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114328416 | Destination Life LLC | Registered Nurse | 1759 Broad Park Cir S Ste 113, Mansfield, TX 76063-7836 | 2014-09-06 |
| 1821699588 | My Nguyen | Registered Nurse | 1759 Broad Park Cir S Ste 113, Mansfield, TX 76063-7836 | 2020-11-07 |
| 1023625894 | Sajourney Pllc | Social Worker | 1759 Broad Park Cir S Ste 113, Mansfield, TX 76063-7836 | 2020-09-25 |
| 1356955884 | Amber S Lockett | Social Worker | 1759 Broad Park Cir S Ste 113, Mansfield, TX 76063-7836 | 2020-09-02 |
| 1134730880 | Lauren E Moss | Social Worker | 1759 Broad Park Cir S Ste 113, Mansfield, TX 76063-7836 | 2020-08-14 |
| 1275159774 | Melanie Canas | Registered Nurse | 1759 Broad Park Cir S Ste 113, Mansfield, TX 76063-7836 | 2020-06-19 |
| 1891319000 | Keri Jo Coleman | Registered Nurse | 1759 Broad Park Cir S Ste 113, Mansfield, TX 76063-7836 | 2020-06-03 |
| 1629691167 | Destination Life LLC | Social Worker | 1759 Broad Park Cir S Ste 113, Mansfield, TX 76063-7836 | 2020-05-19 |
| 1831712413 | Destination Life LLC | Physical Therapist | 1759 Broad Park Cir S Ste 113, Mansfield, TX 76063-7836 | 2020-05-18 |
| 1588287163 | Destination Life LLC | Durable Medical Equipment & Medical Supplies | 1759 Broad Park Cir S Ste 113, Mansfield, TX 76063-7836 | 2020-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| Taxonomy Code | 163WG0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457853442 | Kathy Ann Summers | Registered Nurse | 680 Park Ave W, Mansfield, OH 44906-3706 | 2018-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334902 | Yalennys Liens Aguilar | Registered Nurse | 6711 Rampart St Ste 108, Houston, TX 77081-4265 | 2020-10-22 |
| 1447867650 | Lynn Ellen Mittelstadt | Registered Nurse | 1717 Brooks Ave, Brownwood, TX 76801-7363 | 2020-09-30 |
| 1407463391 | Direct Anchor Healthcare, Inc | Registered Nurse | 2922 Rosedale St Ste 1095, Houston, TX 77004-6188 | 2020-09-25 |
| 1316552755 | Jeanetta Mayberry | Registered Nurse | 103 E Gladiola St, White Oak, TX 75693-1707 | 2020-09-12 |
| 1144832429 | Beverly A Brown | Registered Nurse | 401 Shadow Grass Ave, Fort Worth, TX 76120-1637 | 2020-08-19 |
| 1902414451 | Patricia Kay Rogers | Registered Nurse | 5760 Legacy Dr # B3-145, Plano, TX 75024-7102 | 2020-07-21 |
| 1023636321 | Eleanor Weltge | Registered Nurse | 1415 Nashua St Unit B, Houston, TX 77008-3747 | 2020-07-13 |
| 1427676378 | Karleen Watson | Registered Nurse | 1718 Oneal St, Lancaster, TX 75134-4127 | 2020-07-08 |
| 1396362810 | Darleneya Michelle Robinson | Registered Nurse | 3106 Gladiolus Ln, Dallas, TX 75233-3910 | 2020-06-30 |
| 1629692538 | Rayshard Jarrell Lewis | Registered Nurse | 123 Cavalry Trl, Elgin, TX 78621-4199 | 2020-06-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.