MS. EMILY ELAINE HICKERSON NP NPI 1780024612

NPI Information

NPI: 1780024612
Provider Name: MS. EMILY ELAINE HICKERSON, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
4003 KRESGE WAY STE 300
LOUISVILLE, KY
ZIP 40207
Phone: (502) 897-5139
Get Directions

MS. Emily Elaine Hickerson, NP is a family nurse practitioner in Louisville, KY. MS. Emily Elaine Hickerson, NP NPI is 1780024612. 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:

4003 KRESGE WAY STE 300
LOUISVILLE, KY
ZIP 40207-652
Phone: (502) 897-5139
Fax: (502) 896-6218

The NPI 1780024612 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 6/25/2013 and was last updated on 3/1/2024.

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	363LF0000X	Nurse Practitioner	Family	3008116	KENTUCKY	Yes

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
1	7100259160	MEDICAID	KENTUCKY
2	12569301	OTHER		CAQH

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: 4/28/2024

NPI Synchronization or Removal

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