ELIZABETH ANN HICKSON - NPI 1194752295 - Nurse Practitioner in Golden Valley, MN

Q: What is Elizabeth Hickson's NPI number?

The NPI number for Elizabeth Hickson is 1194752295. It was assigned to this individual provider in the NPPES registry on June 26, 2006.

Q: What is Elizabeth Hickson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Elizabeth Hickson was last updated on June 6, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Elizabeth Ann Hickson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZABETH ANN HICKSON (NPI 1194752295) is an individual family provider in Golden Valley, Minnesota, licensed in Minnesota (R155640-1) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1194752295

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameELIZABETH ANN HICKSON

Location Address1415 LILAC DR N STE 190Golden Valley, MN 55422-4544

Mailing Address1415 Lilac Dr N Ste 190Golden Valley, MN 55422-4544 · (632) 678-7017 · Fax (763) 231-9602

Phone(632) 678-7017

Fax(763) 231-9602

Sole ProprietorNo

Enumeration DateJune 26, 2006

Last NPPES UpdateJune 6, 2019

✔ NPI 1194752295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MN · R155640-1

1415 LILAC DR N STE 190, Golden Valley, MN 55422

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Other Identifiers 1

Medicaid384897300MN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CLEMENCIA RASQUINHA M.D

Family Medicine (Geriatric Medicine)