Individual
ELIZABETH ANN HICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 LILAC DR N STE 190, GOLDEN VALLEY, MN 55422-4544
(632) 678-7017
(763) 231-9602
Mailing address
1415 LILAC DR N STE 190, GOLDEN VALLEY, MN 55422-4544
(632) 678-7017
(763) 231-9602
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R155640-1
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
384897300
—
MN
Enumeration date
06/26/2006
Last updated
06/06/2019
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