Deborah Lee Hickethier, R.N.
Individual provider Active NPI Registered Nurse · Cornell, WI
NPI 1386050334 · NPPES record last updated Jul 9, 2014
Key facts
- NPI
- 1386050334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 193766-30 (WI)
- Practice address
- 25977 205TH Ave
Cornell, WI 54732-5536 - Phone
- (715) 239-6332
- NPI assigned
- Jul 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 193766-30 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 193766-30 | WI | Yes |
| Home Health Registered Nurse | 163WH0200X | 193766-30 | WI |
Addresses
Primary practice location
25977 205TH Ave
Cornell, WI 54732-5536
Mailing address
25977 205TH Ave
Cornell, WI 54732-5536
Phone (715) 239-6332
Other providers in Cornell, WI
- Alicia Hartung Duerst
- Extendicare Homes, Inc.
- FMG North 7TH Street Wisconsin LLC
- Kathryn Franzen
- Natalie Helland
- Kendra Hintz
- Katina Hodgson
- Kerry L Kowalski
- Lakeland Physical Therapy L.L.C.
- James Ward Lane
All providers in Cornell, WI · Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.