Healthcare Provider Details

I. General information

NPI: 1134043771
Provider Name (Legal Business Name): MEGAN HICKERSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7528 OLD LINTON HALL RD
GAINESVILLE VA
20155-1731
US

IV. Provider business mailing address

43254 BALTUSROL TER
ASHBURN VA
20147-5244
US

V. Phone/Fax

Practice location:
  • Phone: 703-686-3507
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0024197270
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: