| NPI | 1366415333 |
|---|---|
| Former Name | BRENDA J. HICKMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 069887) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45182) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2010-09-14 |