TAMARA LYNN HICKMAN CPNP NPI 1699989665

NPI Information

  • NPI: 1699989665
  • Provider Name: TAMARA LYNN HICKMAN, CPNP
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: NORTHWEST MICHIGAN COMMUNITY HEALTH AGENCY
    220 W. GARFIELD STREET
    CHARLEVOIX, MI
    ZIP 49720
  • Phone: (231) 547-6523

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NPI Details

Tamara Lynn Hickman, CPNP is a pediatrics nurse practitioner in Charlevoix, MI. Tamara Lynn Hickman, CPNP NPI is 1699989665. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

NORTHWEST MICHIGAN COMMUNITY HEALTH AGENCY
220 W. GARFIELD STREET
CHARLEVOIX, MI
ZIP 49720
Phone: (231) 547-6523
Fax: (231) 547-6238

The enumeration date for this NPI number is 5/9/2007 and was last updated on 6/28/2016.

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
1363LP0200XNurse PractitionerPediatrics4704113645MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
150-0-A5-1010-0OTHERMICHIGANBCBSM
24868054MEDICAIDMICHIGAN
3TH113645OTHERMICHIGANBCBSM LICENSE NUMBER

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: 11/21/2025

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