MS. MARY A. HICKS (NPI# 1114183647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114183647 |
| Entity Type | Individual |
| Full Name | MS. MARY A. HICKS |
| Other Name | MS. MARY A. HICKS |
| Credential | NURSE PRACTITIONER |
| Practice Address |
13400 S. Pleasant Valley Rd. Imsi Boise ID 83707 |
| Practice Telephone | 2083890230 |
| Practice Fax Number | 2083881778 |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2008-08-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP 144A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | STATE LICENSE NUMBER | NP144A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484254 | Mary Hicks | Registered Nurse | 135 Se County Road 3144, Corsicana, TX 75109-0689 | 2020-07-09 |
| 1205135597 | Mary Jane Hicks | Licensed Practical Nurse | 2506 Davidson Ave, 5e, Bronx, NY 10468-4258 | 2011-03-25 |
| 1699003236 | Mary Hicks | Pharmacist | 800 W Magnolia Ave Ste 130, Fort Worth, TX 76104-4611 | 2009-11-19 |
| 1821288978 | Mary Frances Hicks | Licensed Practical Nurse | 35 Clinton St, Batavia, NY 14020-2822 | 2007-07-25 |
| 1447463989 | Mary Lawrence Hicks | Nurse Practitioner | 995 Potrero Ave # 86, San Francisco, CA 94110-2859 | 2007-05-08 |
| 1447241229 | Mary Hicks | Nurse Practitioner | 1 Ford Pl, Detroit, MI 48202 | 2005-11-02 |
| 1811415474 | Mary Katherine Hicks | Nurse Practitioner | 1030 N Monroe St, Monroe, MI 48162-3113 | 2017-09-05 |
| 1841711462 | Mary Hicks | Counselor | 225 S Main St Ste B, Versailles, KY 40383-1582 | 2017-07-05 |
| 1023410214 | Mary Hicks | Social Worker | 36 Union St., Dryden, NY 13053-0088 | 2014-09-19 |
| 1386903789 | Mary C Hicks | Physical Therapist | 1860 Pennsylvania Ave, Mcdonough, GA 30253-9117 | 2012-05-07 |
| Street Address |
13400 S. PLEASANT VALLEY RD. IMSI |
| City | BOISE |
| State | ID |
| Zip Code | 83707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538514088 | Lyons Physical Therapy | Clinic/Center | 770 S 13th St, Unit 6581, Boise, ID 83707-0002 | 2016-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174411 | K-now Behavioral Solutions, LLC | Behavioral Analyst | 9917 W Antietam St, Boise, ID 83709-3405 | 2020-11-06 |
| 1497356612 | Golden Hour Care Services, LLC | Technician | 3185 S Apple St Apt 104, Boise, ID 83706-6823 | 2020-11-04 |
| 1770183089 | Boise State University | Clinical Medical Laboratory | Bsu Science Bld Room 239 2133 W Cesar Chavez Ln, Boise, ID 83725-0001 | 2020-10-27 |
| 1679172472 | Dynisha Smith | Counselor | 9277 W Shoup Ave, Boise, ID 83709-0557 | 2020-10-22 |
| 1487253233 | Miller Organization LLC | Hearing Instrument Specialist | 7974 W Fairview Ave, Boise, ID 83704-8421 | 2020-10-22 |
| 1568061398 | Nicolette A Eberline | Nurse Practitioner | 4228 W Guard St Bldg 665, Boise, ID 83705-8049 | 2020-10-22 |
| 1215536362 | Daniel & Max, LLC | Optometrist | 1405 N Milwaukee St, Boise, ID 83704-8400 | 2020-10-20 |
| 1740889989 | Sarah Lorraine Gill | Behavior Technician | 1015 W University Dr, Boise, ID 83706-3006 | 2020-10-20 |
| 1124626502 | Michael Corey | Behavior Technician | 4618 W Gage St, Boise, ID 83706-2124 | 2020-10-16 |
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| Find all providers in BOISE | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061398 | Nicolette A Eberline | Nurse Practitioner | 4228 W Guard St Bldg 665, Boise, ID 83705-8049 | 2020-10-22 |
| 1013522275 | Beau Lee | Nurse Practitioner | 2900 N Burton St, Boise, ID 83704-5314 | 2020-09-14 |
| 1588277529 | Tauna Marie Young | Nurse Practitioner | 1681 S Kimball Way, Boise, ID 83709-1654 | 2020-08-28 |
| 1497367114 | Lindsay Ruggles | Nurse Practitioner | 1105 S Federal Way, Boise, ID 83705-2546 | 2020-08-24 |
| 1265056014 | Brynn Crisp | Nurse Practitioner | 1075 N Curtis Rd Ste 100, Boise, ID 83706-1348 | 2020-06-07 |
| 1518592674 | Amber Lynn Gillette | Nurse Practitioner | 1111 S Orchard St Ste 251, Boise, ID 83705-1964 | 2020-03-10 |
| 1265062806 | Jamie Watts | Nurse Practitioner | 5353 W Hill Rd, Boise, ID 83703-2943 | 2020-01-23 |
| 1730654435 | Melissa Gaffrey | Nurse Practitioner | 500 S 8th St, Boise, ID 83702-7107 | 2018-10-09 |
| 1659876399 | Dixie Jean Skinner | Nurse Practitioner | 10583 W. Lake Hazel Rd., Boise, ID 83709-8370 | 2018-03-26 |
| 1063912202 | Devon Moser | Nurse Practitioner | 901 N Curtis Rd Ste 100, Boise, ID 83706-1339 | 2018-02-14 |
| Find all providers in BOISE | ||||
Please comment or provide details below to improve the information on MS. MARY A. HICKS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.