Individual
DARLENE MAY HICKAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
92 W MILLER ST, ORLANDO, FL 32806-2032
(321) 841-4607
(321) 841-4603
Mailing address
92 W MILLER ST, ORLANDO, FL 32806-2032
(321) 841-4607
(321) 841-4603
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN99591
TN
367500000X
Certified Registered Nurse Anesthetist
APN13589
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9332014
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004304300
—
FL
05
—
108054
—
AL
05
—
1509500
—
TN
01
—
4194192
BLUE CROSS BLUE SHIELD TN
TN
05
—
495491926A
—
GA
05
—
8053485
—
NC
01
—
ARNP9332014
MEDICAL LICENSE
FL
01
—
N473106
WELLCARE (GA MEDICAID)
GA
01
—
P00739761
RAILROAD MEDICARE
TN
Enumeration date
07/22/2008
Last updated
11/11/2016
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