Andrea E Hicks, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209.025882 Issued in IL

Practice address

Zvamc 5000 W National Ave
Milwaukee, WI 53295-0001

Phone

(414) 384-2000

NPI assigned

May 3, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1184369100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15000 WESTOVER RD",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531221540",
            "telephone_number": "414-520-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ZVAMC 5000 W NATIONAL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532950001",
            "telephone_number": "414-384-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10400 75th St",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531427884",
            "country_code": "US",
            "telephone_number": "262-948-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "ANDREA",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-03",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.489341",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "123539-30",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "13215",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.025882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184369100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet M Hickle, OTR
• Kawana Latrice Hickman, LPN
• Kevin D Hickman
• Trecia Hickman, RN
• Abigail Hicks, ED.S.
• Benjamin Hicks, DO
• Craig Hicks, OD
• Hilary Jean Hicks, PHD
• Ingrid Diann Hicks, PH.D
• Jena Hicks

• Certified Registered Nurse Anesthetist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.