Active NPI
Sandra Lee Hickman, RNBSN
- Registered Nurse
- Pueblo, CO
National Provider Identifier
1033405675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 73318
- Practice address
- 101 W 9TH St
Pueblo, CO 81003-4103 - Phone
- (719) 583-4308
- Fax
- (719) 583-4375
- NPI assigned
- Jun 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 73318 | CO | Primary |
Addresses
Primary practice location
101 W 9TH St
Pueblo, CO 81003-4103
Mailing address
101 W 9TH St
Pueblo, CO 81003-4103
Phone (719) 583-4308
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 76276848 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73318 | CO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1033405675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W 9TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810034103",
"telephone_number": "719-583-4308",
"fax_number": "719-583-4375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W 9TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810034103",
"telephone_number": "719-583-4308",
"fax_number": "719-583-4375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "SANDRA",
"middle_name": "LEE",
"credential": "RNBSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-22",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CO",
"license": "73318",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "76276848",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.