Individual
CHAMPAGNE HICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 VERMONT AVE, HEMPSTEAD, NY 11550-3445
(516) 450-7896
Mailing address
80 VERMONT AVE, HEMPSTEAD, NY 11550-3445
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
297320-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164W00000X
—
NY
Enumeration date
05/22/2019
Last updated
05/22/2019
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