Laura Hickenbottom
Nurse Practitioner - Neonatal
611 W. Park St. Neonatology
Urbana
, Illinois 61801-2500
Laura Hickenbottom
Nurse Practitioner - Neonatal
611 W. Park St. Neonatology
Urbana
, Illinois 61801-2500
(217) 383-6941
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About
Features
Specialties
- Nurse Practitioner - Neonatal
Languages spoken
- English
Location
First Address
- Laura Hickenbottom
- 611 W. Park St. Bwpc
- Urbana, IL
- Zip : 61801-2500
- Phone : (217) 383-6941
Second Address
- Laura Hickenbottom
- 611 W. Park St. Neonatology
- Urbana, IL
- Zip : 61801-2500
- Fax : (217) 383-3463
- Phone : (217) 383-3266
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 363LN0000X | Nurse Practitioner - Neonatal | 2014040196 | MO |
| Y | 363LN0000X | Nurse Practitioner - Neonatal | 209014221 | IL |
National Provider Identifier
| NPI | 1043617665 |
|---|---|
| Provider Name | Laura Hickenbottom |
| First Address | Urbana, IL 61801-2500 |
| Second Address | Urbana, IL 61801-2500 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/11/2014 |
| Last Update Date | 10/12/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.