Provider Demographics
NPI:1356236061
Name:HICKMAN TAYLOR
Entity type:Organization
Organization Name:HICKMAN TAYLOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-704-6766
Mailing Address - Street 1:5596 BLUEGRASS DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-2956
Mailing Address - Country:US
Mailing Address - Phone:678-704-6766
Mailing Address - Fax:678-704-6766
Practice Address - Street 1:5596 BLUEGRASS DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-2956
Practice Address - Country:US
Practice Address - Phone:678-704-6766
Practice Address - Fax:678-704-6766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332U00000XSuppliersHome Delivered Meals
No174200000XOther Service ProvidersMeals