| Doctor Name: | NICHOLE HICKMAN |
| NPI Number: | 1003802067 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 71001444A |
| Business Practice Address: | 350 S Landmark Ave Bloomington, IN - 474035001 |
| Business Phone Number: | 8123352434 |
| Business Fax Number: | 8123357604 |
| Mailing Address: | 350 S Landmark Ave, BLOOMINGTON |
| State: | IN |
| Postal Code: | 474035001 |
| Phone Number: | 8123352434 |
| Fax Number: | 8123357604 |
| NPI Enumeration Date: | 09/26/2005 |
| NPI Last Update Date: | 12/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 71001444A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |