MEDICARE: HILARY ANN LICARDI ARNP

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	ARNP2129202	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992043863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILARY ANN LICARDI ARNP

Provider Business Mailing Address
First Line	:	PO BOX 1189
Second Line	:
City	:	CORVALLIS
State	:	OR
Zip	:	97339-1189
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 EVERGREEN PL SE
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97322
Country	:	US
Telephone Number	:	541-812-4662
Fax Number	:

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

Provider Enumeration Date	:	01/28/2013
Last Update Date	:	01/06/2026

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