Provider Demographics
NPI:1538516604
Name:HICKS, SINQUETA KATRINA (FNP)
Entity Type:Individual
Prefix:MS
First Name:SINQUETA
Middle Name:KATRINA
Last Name:HICKS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2344 BOSTON RD APT 4W
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-9046
Mailing Address - Country:US
Mailing Address - Phone:646-246-1054
Mailing Address - Fax:
Practice Address - Street 1:472 PALMER RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-5207
Practice Address - Country:US
Practice Address - Phone:914-375-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily