Healthcare Provider Details

I. General information

NPI: 1699746099
Provider Name (Legal Business Name): PATRICK E HICKEY ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1773 W SAINT MARYS RD STE 105
TUCSON AZ
85745-2654
US

IV. Provider business mailing address

2851 S AVENUE B BLDG 4
YUMA AZ
85364-7726
US

V. Phone/Fax

Practice location:
  • Phone: 520-622-8357
  • Fax: 520-622-1028
Mailing address:
  • Phone: 928-376-0026
  • Fax: 928-782-2298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3122672
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberMSL3122672FL
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP3122672
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: