AGWANDA M HICKMAN (NPI# 1811248057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811248057 |
| Entity Type | Individual |
| Full Name | AGWANDA M HICKMAN |
| Credential | APN |
| Practice Address |
570 Egg Harbor Rd C2 Sewell NJ 08080-2359 |
| Practice Telephone | 8562180300 |
| Practice Fax Number | 8565895082 |
| Mailing Telephone | 8562180300 |
| Mailing Fax Number | 8565895082 |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2016-12-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
26NJ00396900 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0335487 | 05 |
| Street Address |
570 EGG HARBOR RD C2 |
| City | SEWELL |
| State | NJ |
| Zip Code | 08080-2359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578569265 | Jeffrey Peter Kovacs | Orthopaedic Surgery | 570 Egg Harbor Rd, Suite C4, Sewell, NJ 08080-2359 | 2005-06-27 |
| 1003281080 | Kennedy Medical Group Practice, P.C. | Surgery | 570 Egg Harbor Rd, Suite C-2, Sewell, NJ 08080-2359 | 2015-12-02 |
| 1336515360 | Megan Andrade | Physical Therapist | 570 Egg Harbor Rd, Suite B6, Sewell, NJ 08080-2359 | 2015-08-13 |
| 1891191201 | Reconstructive Orthopedics, P.a. | Physical Medicine & Rehabilitation | 570 Egg Harbor Rd, Suite C-4, Sewell, NJ 08080-2359 | 2014-11-12 |
| 1992128094 | Amanda O'loughlin | Physical Therapist | 570 Egg Harbor Rd, Suite B6, Sewell, NJ 08080-2359 | 2014-01-24 |
| 1568896579 | Ashley Nelson | Physical Therapist | 570 Egg Harbor Rd, Suite B6, Sewell, NJ 08080-2359 | 2013-08-27 |
| 1609200070 | Ariel Dubois | Physical Therapist | 570 Egg Harbor Rd, Sewell, NJ 08080-2359 | 2013-08-21 |
| 1780925354 | Theresa Marie Campanella | Physical Therapist | 570 Egg Harbor Rd, Suite B6, Sewell, NJ 08080-2359 | 2013-03-07 |
| 1912256421 | Adam P Dezii | Physical Therapist | 570 Egg Harbor Rd, Suite B-6, Sewell, NJ 08080-2359 | 2012-08-30 |
| 1326336694 | Richard G. Hubler Jr. | Physical Therapist | 570 Egg Harbor Rd, Harbor Pavillions Suite B6, Sewell, NJ 08080-2359 | 2011-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679180301 | Peter Ansong | Pharmacist | 500 Egg Harbor Road, Sewell, NJ 08080 | 2020-09-27 |
| 1477018752 | Shi-iii Washington Township LLC | Alzheimer Center (Dementia Center) | 339 Greentree Road, Washington Township, NJ 08080 | 2019-01-31 |
| 1245741495 | Assoc. for Retarded Citizens. Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Fawn Drive, Sewell, NJ 08080 | 2017-10-16 |
| 1851802029 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 275 Greentree Road, Sewell, NJ 08080 | 2017-10-16 |
| 1598284770 | Bryan Hendricks | Psychologist | 123 Egg Harbor Rd., Suite 302, Sewell, NJ 08080 | 2017-09-19 |
| 1912426339 | Mary Faralli | Speech-Language Pathologist | 24 Upton Way, Sewell, NJ 08080 | 2017-09-18 |
| 1669990578 | Oaks Integrated Care | Clinic/Center | 322 Fishpond Rd, Sewell, NJ 08080 | 2017-08-31 |
| 1972032316 | Nutan K Ravani | Social Worker | 3 Heritage Valley Drive, Sewell, NJ 08080 | 2017-06-08 |
| 1447784038 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 224 West Warren Avenue, Sewell, NJ 08080 | 2017-04-20 |
| 1326572173 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 363 Ganttown Road, Turnersville, NJ 08080 | 2017-04-19 |
| Find all providers in zip 08080 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659870848 | Michael David Ruppert Jr. | Nurse Practitioner | 475 Hurffville Crosskeys Rd Ste B, Sewell, NJ 08080-2320 | 2018-02-02 |
| 1609374479 | Mae N Dechristy | Nurse Practitioner | 239 Hurfville-cross Keys Road, Suite 480, Sewell, NJ 08080-4009 | 2018-01-26 |
| 1699211029 | Katherine Stoudt | Nurse Practitioner | 123 Egg Harbor Rd Ste 604, Sewell, NJ 08080-9408 | 2017-01-09 |
| 1023358561 | Hospital To Home Transitional Diabetes Care Limited Liability Company | Nurse Practitioner | 67 Stratton Ln, Sewell, NJ 08080-2253 | 2013-02-20 |
| 1598000200 | Chinmaeze Wachuku Nnanji | Nurse Practitioner | 221 Boothby Ct, Sewell, NJ 08080-2504 | 2012-12-06 |
| 1578859229 | Miriam Uzoamaka Nnabuihe | Nurse Practitioner | 302 Hurffville Crosskeys Rd Ste A1, Sewell, NJ 08080-9206 | 2011-06-21 |
| 1154358810 | Florence E Snyder | Nurse Practitioner | 307 Egg Harbor Rd, Sewell, NJ 08080-9406 | 2006-06-27 |
| 1649269309 | Dorothy Iannaco | Nurse Practitioner | 239 Hurffville Crosskeys Rd, Suite 160, Sewell, NJ 08080-4002 | 2005-10-17 |
| 1386257632 | Tara Ricciardi | Nurse Practitioner | 378 Fries Mill Rd, Sewell, NJ 08080-9203 | 2020-08-26 |
| 1134764947 | Jaclyn Teresa Thatcher | Nurse Practitioner | 565 Egg Harbor Rd, Sewell, NJ 08080-2335 | 2019-11-15 |
| Find all providers in SEWELL | ||||
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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.