Individual
NICOLE HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STUDENT
Contact information
Practice address
312 9TH ST SW, WAVERLY, IA 50677-2999
(319) 352-4120
Mailing address
427 N MAPLE ST, JANESVILLE, IA 50647-1021
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D174685
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2021
Last updated
04/10/2024
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