Provider Demographics
NPI:1841392347
Name:HICKEY, KAREN ANN (FAMILY NURSE PRACTI)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:HICKEY
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 7359
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78713-7339
Mailing Address - Country:US
Mailing Address - Phone:512-475-8394
Mailing Address - Fax:612-659-7101
Practice Address - Street 1:100 WEST DEAN KEETON
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712-1107
Practice Address - Country:US
Practice Address - Phone:512-475-8394
Practice Address - Fax:612-659-7101
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX626884363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner