Sandra E. Hickman, FNP
Individual provider Active NPI Family Nurse Practitioner · Gray, TN
NPI 1922181973 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1922181973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APN5142 (TN)
- Practice address
- 1440 Suncrest Dr
Gray, TN 37615-4118 - Phone
- (423) 477-1634
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN5142 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Tennessee State University | Past | Accepting new patients | |
| East Tennessee State University | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APN5142 | TN | Yes |
Addresses
Primary practice location
1440 Suncrest Dr
Gray, TN 37615-4118
Mailing address
PO Box 70403
Johnson City, TN 37614-1703
Phone (423) 439-4078
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| APN5142 | Other | TN | APN LICENSE |
Other providers in Gray, TN
- Hall Family Chiropractic Center
- Ricky Hall
- Amanda D Hamby
- Elizabeth A Hamm
- Melinda Haskett
- Jessica Joy Hicks
- Collette McWilliams Hoilman
- Erica Lynn Hubbard
- Shirley Ann Hubbard
- John Tyson Huff
All providers in Gray, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.