Provider Demographics
NPI:1013914837
Name:HICKS, SARAH ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:HICKS
Suffix:
Gender:F
Credentials:PA-C
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 603949
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3949
Mailing Address - Country:US
Mailing Address - Phone:919-350-0351
Mailing Address - Fax:919-350-7687
Practice Address - Street 1:210 ASHVILLE AVE
Practice Address - Street 2:SUITE 440
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6600
Practice Address - Country:US
Practice Address - Phone:919-350-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06301363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7048908OtherCIGNA
FLP1019783OtherFREEDOM
NC1013914837Medicaid
FLP01213609OtherRR MEDICARE
FLP958311OtherOPTIMUM
FLY0J2ZOtherBCBS OF FL
FL009563500Medicaid
FL5813921OtherAETNA
FLP01213609OtherRAILROAD MCR
FLP01213609OtherRAILROAD MCR
FL5813921OtherAETNA
FLP1019783OtherFREEDOM