Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APRN.CNP.023480 | OH |
Y | 363LN0000X | Nurse Practitioner - Neonatal | 3012898 | KY |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 0992646 | CO |
NPI | 1356885305 |
---|---|
Provider Name | Mrs. Emily Anne Hickerson |
First Address | Crestwood, KY 40014-7728 |
Second Address | Lexington, KY 40503-1431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2016 |
Last Update Date | 01/12/2021 |