Healthcare Provider Details

I. General information

NPI: 1487289823
Provider Name (Legal Business Name): APRIL THERESA HICKMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 04/03/2020
Certification Date: 04/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1343 N FOUNTAIN BLVD
SPRINGFIELD OH
45504-1461
US

IV. Provider business mailing address

1701 MERCY HEALTH PL
CINCINNATI OH
45237-6147
US

V. Phone/Fax

Practice location:
  • Phone: 937-523-9050
  • Fax:
Mailing address:
  • Phone: 888-696-3541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.026453
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: