MEDICARE: MR. PATRICK E HICKEY ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	3122672	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	MSL3122672FL	AZ
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	ARNP3122672	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699746099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PATRICK E HICKEY ARNP

Provider Business Mailing Address
First Line	:	2851 S AVENUE B BLDG 4
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-7726
Country	:	US
Telephone Number	:	928-376-0026
Fax Number	:	928-782-2298

Provider Business Practice Location Address
First Line	:	1773 W SAINT MARYS RD STE 105
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-2654
Country	:	US
Telephone Number	:	520-622-8357
Fax Number	:	520-622-1028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	11/06/2025

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