Individual provider Active NPI

Nancy Hickerson, BSRN, PHN

  • Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1679938138
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R-153677-7 Issued in MN
Practice address
2000 Summer St NE
Minneapolis, MN 55413-2648
Phone
(612) 617-4600
NPI assigned
Dec 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R-153677-7 MN Primary
Community Health Registered Nurse 163WC1500X 14602 MN

Addresses

Primary practice location

2000 Summer St NE
Minneapolis, MN 55413-2648

Mailing address

2000 Summer St NE
Minneapolis, MN 55413-2648
Phone (612) 617-4600

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

LicenseStateTypeSpecialty
14602MNMDClinical Social Worker
R-153677-7MNMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1679938138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 SUMMER ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132648",
            "telephone_number": "612-617-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 SUMMER ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132648",
            "telephone_number": "612-617-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKERSON",
        "first_name": "NANCY",
        "credential": "BSRN, PHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-28",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R-153677-7",
            "primary": true
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "MN",
            "license": "14602",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.