Individual
MINDY LYNN HICKENBOTTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
111 S GRANT AVE, COLUMBUS, OH 43215
(614) 566-9160
Mailing address
5450 FRANTZ RD STE 360, DUBLIN, OH 43016-4141
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.307815
OH
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN.CNP.022912
OH
Other
Enumeration date
04/27/2018
Last updated
06/11/2019
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