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General NPI Number Information
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NPI Number | 1821224635
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Entity Type | Individual
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Provider Name | RYAN-NIKO HICKMAN MD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2009
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 9320 W. SAHARA AVE.
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City | LAS VEGAS
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State | NV
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Zip | 89117
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Country | US
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Telephone | 702-383-3850
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Fax | 702-562-2816
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Provider Business Mailing Address
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Address Line | 1800 W. CHARLESTON BLVD. STE. 508
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City | LAS VEGAS
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State | NV
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Zip | 89102
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Country | US
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Telephone | 702-383-2688
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Fax | 928-263-5298
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 321356
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 56829
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 39988
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 036.128902
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 2011-00129
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | MD482065
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License Number State | PA
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Taxonomy #7
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 74809
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License Number State | MN
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Taxonomy #8
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 96415
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License Number State | GA
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Taxonomy #9
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 01091130A
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License Number State | IN
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Taxonomy #10
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 3272-320
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License Number State | WI
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Taxonomy #11
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 2023031397
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License Number State | MO
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Taxonomy #12
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 077147
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License Number State | CT
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Taxonomy #13
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 25IA12394200
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License Number State | NJ
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Taxonomy #14
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | C1-0027118
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License Number State | DE
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Taxonomy #15
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 19328
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License Number State | NV
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