Hickson, Elizabeth Ann

Hickson, Elizabeth Ann is an individual health care provider with primary practice located at 1415 Lilac Dr N Ste 190 , Golden Valley MN 55422-4544. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Hickson, Elizabeth Ann can be contacted via phone (632) 678-7017.

Contact Information

Primary practice address
1415 Lilac Dr N Ste 190 Golden Valley MN 55422-4544
Phone: (632) 678-7017
Fax: (763) 231-9602
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R155640-1 Minnesota

Profile Details

NPI number 1194752295
LBN Legal business name Hickson, Elizabeth Ann
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Jun 6th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194752295 NPPES
Minnesota MEDICAID 384897300

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