1942507074 NPI number — MS. NATALIE BANKS HICKMAN REGISTERED NURSE

Table of content: MS. NATALIE BANKS HICKMAN REGISTERED NURSE (NPI 1942507074)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942507074 NPI number — MS. NATALIE BANKS HICKMAN REGISTERED NURSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HICKMAN
Provider First Name:
NATALIE
Provider Middle Name:
BANKS
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
REGISTERED NURSE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FIGUEROA
Provider Other First Name:
NATALIE
Provider Other Middle Name:
BANKS
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942507074
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/14/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BADEN STREET SETTLEMENT OF ROCHESTER
Provider Second Line Business Mailing Address:
585 JOSEPH AVENUE
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-325-4910
Provider Business Mailing Address Fax Number:
585-546-1491

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BADEN STREET SETTLEMENT OF ROCHESTER
Provider Second Line Business Practice Location Address:
585 JOSEPH AVENUE
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-325-4910
Provider Business Practice Location Address Fax Number:
585-546-1491
Provider Enumeration Date:
02/25/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  555171 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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