LATRICIA DELORIS HICKENBOTTOM (NPI# 1700343811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700343811 |
| Entity Type | Individual |
| Full Name | LATRICIA DELORIS HICKENBOTTOM |
| Credential | CRNP |
| Practice Address |
1515 S University Blvd Mobile AL 36609-2958 |
| Mailing Address |
3581 Meadow Ln E Mobile AL 36618-3603 |
| Practice Telephone | 2513439600 |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
1-134340 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1515 S UNIVERSITY BLVD |
| City | MOBILE |
| State | AL |
| Zip Code | 36609-2958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497097265 | Lesley Anne Druckenmiller | Occupational Therapist | 1515 S University Blvd, Mobile, AL 36609-2958 | 2013-03-20 |
| 1912539495 | Kathryn T Thompson | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2020-02-12 |
| 1881252476 | Sharon L Woody | Occupational Therapist | 1515 S University Blvd, Mobile, AL 36609-2958 | 2019-05-30 |
| 1841752052 | Courtnee Criswell Stagner | Registered Nurse | 1515 S University Blvd, Mobile, AL 36609-2958 | 2019-04-05 |
| 1144786849 | Stacey Lanham | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2019-02-18 |
| 1730674417 | Melissa Wolff | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2018-06-26 |
| 1508355694 | Deanna Markris | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2018-05-04 |
| 1568969848 | Whitney Denys Sims | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2018-04-12 |
| 1043748346 | Jennifer Denise Thomas | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2017-05-31 |
| 1255876231 | Saad Enterprises, Inc. | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2016-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821698309 | Bhg Lxxii, LLC | Clinic/Center | 4373 Dowtowner Loop South, Suite A, Mobile, AL 36609 | 2020-10-26 |
| 1760036008 | Jesse David Schultz | Chiropractor | 3501 Montlimar Plaza Drive, Mobile, AL 36609 | 2019-07-25 |
| 1982267241 | Raqueal L. Williams | Registered Nurse | 406 Larose Dr., Mobile, AL 36609 | 2019-04-22 |
| 1588131924 | Angela Roney | Counselor | 705 Oak Circle Dr. East, Mobile, AL 36609 | 2018-10-24 |
| 1134617996 | Harley Michelle Oliver | Physician Assistant | 820 S. University Blvd Bldg 1, Suite 1b, Mobile, AL 36609 | 2018-04-27 |
| 1912420126 | Rural Urgent Care LLC | Clinic/Center | 6280 Grelot Road, Mobile, AL 36609 | 2017-07-19 |
| 1598128407 | Trisha Mcmillon | Counselor | 3929 Airport Blvd Ste 1-214, Mobile, AL 36609 | 2016-03-30 |
| 1437523347 | Sonya White D.d.s. PC | Dentist | 6309 Piccadilly Square Dr., Mobile, AL 36609 | 2015-11-17 |
| 1386913374 | Janis Marie Fausser | Pharmacist | 5705 Cottagehill Rd, Mobile, AL 36609 | 2011-12-20 |
| 1245524263 | Emily Chisholm | Physical Therapist | 1515 University Blvd. S., Mobile, AL 36609 | 2011-06-07 |
| Find all providers in zip 36609 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730720244 | Carl B Regaliza | Nurse Practitioner | 1551 Old Shell Rd, Mobile, AL 36604-1354 | 2019-10-06 |
| 1104471978 | Stephanie Ann Fouts | Nurse Practitioner | 6701 Airport Blvd., B Bldg., T Level, Mobile, AL 36608-3764 | 2019-08-07 |
| 1366004350 | William Augustus Mcmurray Iv | Nurse Practitioner | 2451 University Hospital Dr, Mstn 101, Mobile, AL 36617-2238 | 2019-07-01 |
| 1508355694 | Deanna Markris | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2018-05-04 |
| 1043748346 | Jennifer Denise Thomas | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2017-05-31 |
| 1922543487 | Denesha Johnson | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2016-12-19 |
| 1922461995 | Alicia Land | Nurse Practitioner | 6701 Airport Blvd, 'b' Bldg., 't' Level, Mobile, AL 36608-6705 | 2016-03-29 |
| 1518329630 | Dorothy Kastrinos | Nurse Practitioner | 1758 Spring Hill Ave, Mobile, AL 36607-3508 | 2016-03-28 |
| 1104216845 | Kathleen J Ferguson | Nurse Practitioner | 75 S University Blvd, Ucom 6000 A, Mobile, AL 36688-0002 | 2015-02-03 |
| 1487076873 | Michelle Ann Sanford | Nurse Practitioner | 3719 Dauphin St, 5th Floor, Mobile, AL 36608-1753 | 2014-01-20 |
| Find all providers in MOBILE | ||||
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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.