Individual provider Active NPI

Jennifer Lynn Hickman, FNP

  • Family Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1952541971
Registry record updated Aug 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30006747 Issued in WA
Practice address
427 S Bernard St
Spokane, WA 99204-2509
Phone
(509) 456-8150
NPI assigned
Mar 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10004824 WA
Family Nurse Practitioner 363LF0000X NP-591A ID
Family Nurse Practitioner 363LF0000X AP30006747 WA Primary

Addresses

Primary practice location

427 S Bernard St
Spokane, WA 99204-2509

Mailing address

PO Box 3649
Spokane, WA 99220-3649
Phone (509) 342-3758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110131001014 WA Practitioner - Nurse Practitioner 0446293153 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Family Medicine CurrentSince Mar 1, 2018 Accepting new patients
Kaiser Foundation Health Plan of Washington Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503014400000",
    "number": "1952541971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3649",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203649",
            "telephone_number": "509-342-3758",
            "fax_number": "509-342-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 S BERNARD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042509",
            "telephone_number": "509-456-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2017-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004824",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-591A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30006747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.