Provider Demographics
NPI:1578241709
Name:HICKMAN, LAUREN E (FNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:HICKMAN
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:PO BOX 26194
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2012
Mailing Address - Country:US
Mailing Address - Phone:833-908-0990
Mailing Address - Fax:833-908-0998
Practice Address - Street 1:11130 KINGSTON PIKE STE 7&8
Practice Address - Street 2:
Practice Address - City:FARRAGUT
Practice Address - State:TN
Practice Address - Zip Code:37934-2865
Practice Address - Country:US
Practice Address - Phone:865-675-1953
Practice Address - Fax:833-908-2090
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34096363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily