Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Holly Hicks-Deridder, PA-C

Individual provider Medical Physician Assistant · NPI 1578641627

Holly Hicks-Deridder, PA-C is a Medical Physician Assistant in Newnan, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2700 Highway 34 E Bldg 300
Newnan, GA 30265-1330
Phone: (770) 304-0987
Fax: (770) 251-0938
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 003338 (GA)

Record details

NPI number1578641627
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedNovember 2, 2006
Last updated in NPPESNovember 1, 2011

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