JACOB WAYNE HICKSON NPI 1609453497

NPI Information

NPI: 1609453497
Provider Name: JACOB WAYNE HICKSON
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Organization: MEDSTAR MEDICAL GROUP II LLC

PECOS Registration: Yes

Address:
2112 NEW HAMPSHIRE AVE NW APT 1007
WASHINGTON, DC
ZIP 20009
Phone: (601) 422-9537
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Jacob Wayne Hickson is an acute care nurse practitioner in Washington, DC with 4 years of experience. Jacob Wayne Hickson NPI is 1609453497. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2112 NEW HAMPSHIRE AVE NW APT 1007
WASHINGTON, DC
ZIP 20009-530
Phone: (601) 422-9537

The NPI 1609453497 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/26/2021 and was last updated on 3/26/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	RN1036244	DISTRICT OF COLUMBIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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