Individual
ANDREA E HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
ZVAMC 5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
Mailing address
15000 WESTOVER RD, ELM GROVE, WI 53122-1540
(414) 520-2118
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.489341
IL
163W00000X
Registered Nurse
123539-30
WI
367500000X
Certified Registered Nurse Anesthetist
13215
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
209.025882
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184369100
—
WI
Enumeration date
05/03/2022
Last updated
09/11/2024
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