Individual
MS. EMILY ELAINE HICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4003 KRESGE WAY STE 300, LOUISVILLE, KY 40207-4652
(502) 897-5139
(502) 896-6218
Mailing address
5200 COMMERCE CROSSINGS DR FL 3, LOUISVILLE, KY 40229-2182
(502) 253-4924
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3008116
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12569301
CAQH
—
05
—
7100259160
—
KY
Enumeration date
06/25/2013
Last updated
03/01/2024
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