Freddie Hicks, APRN
Individual provider Active NPI Family Nurse Practitioner · Little Rock Afb, AR
NPI 1407472020 · NPPES record last updated Jun 9, 2023
Key facts
- NPI
- 1407472020
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 123341 (AR)
- Practice address
- 1090 Arnold Dr
Little Rock Afb, AR 72099-5001 - Phone
- (501) 987-2932
- NPI assigned
- Jun 19, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210506001328 | AR | Practitioner - Nurse Practitioner | 1254740004 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123341 | AR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healogics Specialty Physicians of Arkansas, PLLC | Current |
Accepting new patients | |
| Curana Health of Arkansas LLC | Family | Current |
Accepting new patients |
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients | |
| Apex Wound Specialists, LLC | Current |
Accepting new patients | |
| Southeast Arkansas Five Medical Group, PLLC | Past | Accepting new patients | |
| Wound Solutions of Nwa, LLC | Past | Accepting new patients | |
| Icarepro of Texas, PA | Past | Accepting new patients |
Locations
609 SW 8th St
Fl 6
Bentonville, AR 72712
Phone (479) 349-2579
3017 N Bob Younkin Dr
Ste 102
Fayetteville, AR 72703
Phone (479) 463-4325
1818 N Taylor St
Ste 167
Little Rock, AR 72207
Phone (904) 446-3764
3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000
1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 123341 | AR | Yes |
Addresses
Primary practice location
1090 Arnold Dr
Little Rock Afb, AR 72099-5001
Mailing address
1090 Arnold Dr
Little Rock Afb, AR 72099-4933
Phone (501) 987-2932
Other providers in Little Rock Afb, AR
- Brady Hansen
- Marilyn Jeanne Hardy
- Susanne Havel
- Andrew M Hefner
- Keisha Denythia Henry
- Emily M Holmes
- Patricia Ellen Hoogeveen
- Catrina Yvette Horn
- Joel Hutchison
- Melrita Maechel Johnson
All providers in Little Rock Afb, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.