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General NPI Number Information
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NPI Number | 1003434473
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Entity Type | Individual
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Provider Name | AMANDA B HICKS DNP, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/11/2020
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 1930 BISHOP LN FL 12
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City | LOUISVILLE
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State | KY
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Zip | 40218-1921
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Country | US
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Telephone | 502-272-5220
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Fax | 502-272-5117
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Provider Business Mailing Address
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Address Line | PO BOX 932958
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City | CLEVELAND
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State | OH
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Zip | 44193-0028
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3014696
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License Number State | KY
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