Individual
MS. KIM LORRAINE HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
10000 BAY PINES BLVD, BAY PINES, FL 33744-8200
(727) 410-3967
(727) 502-1750
Mailing address
PO BOX 5005, BAY PINES, FL 33744-5005
(727) 410-3967
(727) 502-1750
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN1697342
FL
Other
Enumeration date
04/16/2012
Last updated
04/16/2012
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