Provider Demographics
NPI:1932448321
Name:HICKS, MARTHA MICHELLE (ARNP)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:MICHELLE
Last Name:HICKS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:
Other - Last Name:MURPHY, MCNEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:239-599-2612
Practice Address - Street 1:1132 S 14TH ST
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-2920
Practice Address - Country:US
Practice Address - Phone:904-277-4690
Practice Address - Fax:904-277-8487
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9237030363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008279100Medicaid
FLGZ748ZMedicare PIN
FLGZ748YMedicare PIN