Jill Lynn Hicks, RN, EMT-P

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

4704284360 Issued in MI

Practice address

420 W 5TH Ave
Flint, MI 48503-2445

Phone

(810) 280-5125

NPI assigned

Feb 11, 2021

Last updated

Feb 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Emergency Medical Technician - Paramedic, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michigan Mobile Forensics 1

  • Registered Nurse
  • Fenwick, MI
  • NPI 1649136714
  NPD Authorized official

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1720671696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10220 W HERBISON RD",
            "city": "EAGLE",
            "state": "MI",
            "postal_code": "488229743",
            "telephone_number": "810-280-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 5TH AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032445",
            "telephone_number": "810-280-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JILL",
        "middle_name": "LYNN",
        "credential": "RN, EMT-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MI",
            "license": "4704284360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "VPN",
            "affiliation": "N",
            "endpointDescription": "VPN",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CHIP",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CHIP",
            "address_1": "420 W 5th Ave",
            "city": "Flint",
            "state": "MI",
            "country_code": "US",
            "postal_code": "485032445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CHIP",
            "affiliation": "Y",
            "endpointDescription": "CHIP",
            "affiliationName": "Genesee County Health System",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CHIP",
            "address_1": "420 W 5th Ave",
            "city": "Flint",
            "state": "MI",
            "country_code": "US",
            "postal_code": "485032445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hickory Hollow Specialized Residential
• Camillia Annett Hicks
• Crystal Hicks, BS
• Heather Hicks
• Jeanne Koistinen Hicks, MD
• Randy David Hicks, MD
• Sydney Hicks
• Matthew Hiestand
• Angelya Higginbotham, MPH
• Carol A Higgins, CNP

• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Flint, MI
• Providers in Flint, MI by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.