MEDICARE: STEPHANIE HICKERSON-JONES CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1-116758	AL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN241773	GA

General Provider Information

NPI Number	:	1275946402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE HICKERSON-JONES CNP

Provider Business Mailing Address
First Line	:	2123 EXECUTIVE PARK DR
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-6041
Country	:	US
Telephone Number	:	334-275-9595
Fax Number	:	706-223-1934

Provider Business Practice Location Address
First Line	:	2123 EXECUTIVE PARK DR
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-6041
Country	:	US
Telephone Number	:	334-275-9595
Fax Number	:	706-223-1934

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2014
Last Update Date	:	12/09/2025

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