MEDICARE: SUNIKO M HICKMAN FNP

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	363LF0000X	Family Nurse Practitioner	RN213921	GA

General Provider Information

NPI Number	:	1912629593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNIKO M HICKMAN FNP

Provider Business Mailing Address
First Line	:	3923 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-1916
Country	:	US
Telephone Number	:	929-491-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	3923 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-1916
Country	:	US
Telephone Number	:	929-491-7700
Fax Number	:

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

Provider Enumeration Date	:	09/12/2022
Last Update Date	:	09/12/2022

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