MISS PAIGE JENNIFER HICKSON (NPI# 1568425973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568425973 |
| Entity Type | Individual |
| Full Name | MISS PAIGE JENNIFER HICKSON |
| Other Name | PAIGE CHAPMAN |
| Credential | PA-C |
| Practice Address |
6100 Newport Road, Suite 100 Kalamazoo Dermatology, P.C. Portage MI 49002-9235 |
| Mailing Address |
6100 Newport Rd Ste 100 Portage MI 49002-9235 |
| Practice Telephone | 2693434679 |
| Practice Fax Number | 2693435929 |
| Mailing Telephone | 2693434679 |
| Mailing Fax Number | 2693435929 |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2017-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MI | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
5601004610 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6100 NEWPORT ROAD, SUITE 100 KALAMAZOO DERMATOLOGY, P.C. |
| City | PORTAGE |
| State | MI |
| Zip Code | 49002-9235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932604204 | Susan Vandewalker | Physical Therapist | 8001 Angling Rd., Portage, MI 49002 | 2018-03-28 |
| 1134634934 | Portage Chiropractic and Wellness Center | Chiropractor | 609 E. Centre, Portage, MI 49002 | 2017-12-04 |
| 1548620537 | Patricia Eid | Behavioral Analyst | 1016 E Milham Ave, Suite 2, Portage, MI 49002 | 2016-03-03 |
| 1386045383 | Pinnacle Senior Care of Kalamazoo, LLC | Home Health | 2725 Airview Blvd Ste 105b, Portage, MI 49002 | 2014-09-09 |
| 1104241611 | Meredith Ayers Holland | Behavioral Analyst | 9616 Portage Road, Portage, MI 49002 | 2014-02-20 |
| 1619211919 | Daketia L Thomas | Massage Therapist | 8314 Portage Rd, Suite D, Kalamazoo, MI 49002 | 2012-11-27 |
| 1831457142 | Kinetic Kids, LLC | Occupational Therapist | 540 East Milham, Portage, MI 49002 | 2012-04-25 |
| 1154689404 | Lauren Michelle Mattaliano | Occupational Therapist | 540 E. Milham Road, Portage, MI 49002 | 2012-04-24 |
| 1114219227 | South Michigan Psychiatric Services LLC | Psychiatry & Neurology | 5390 Lovers Ln, Third Floor, Portage, MI 49002 | 2011-05-07 |
| 1174836316 | Premier Neuropsychiatry Plc | Psychiatry & Neurology | 5930 Lovers Lane, Portage, MI 49002 | 2010-07-16 |
| Find all providers in zip 49002 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1609069566 | Jacqueline J James | Physician Assistant | 3000 Old Centre Road, Southwest Michigan Dermatology, A Division of Paragon H, Portage, MI 49024 | 2007-08-23 |
| 1528150893 | Michael Maurice Claussen | Physician Assistant | 3200 W Centre St, Suite 203, Portage, MI 49024 | 2006-09-28 |
| 1215917836 | Shanae A Hanoute | Physician Assistant | 2600 W Centre Ave, Portage, MI 49024-4828 | 2006-01-19 |
| 1003479445 | Brittany Rose Doxey | Physician Assistant | 1324 W Milham Ave, Portage, MI 49024-2239 | 2019-04-22 |
| 1902387962 | Amelia Louise Evenhouse | Physician Assistant | 3850 Glenkerry Ct, Portage, MI 49024-0700 | 2018-08-27 |
| 1932658184 | Kayla Chapman | Physician Assistant | 3000 Old Centre Rd, Portage, MI 49024 | 2016-09-29 |
| 1689056376 | Kristen Marie Moran | Physician Assistant | 7901 Angling Rd, Portage, MI 49024-0714 | 2015-06-18 |
| 1710389853 | Shantel Lynn Bleeker | Physician Assistant | 3304 Cooley Ct, Portage, MI 49024 | 2014-09-19 |
| 1407281108 | Cristy J Burghardt | Physician Assistant | 3000 Old Centre Rd, Portage, MI 49024-4883 | 2013-09-12 |
| Find all providers in PORTAGE | ||||
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| 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.