LESLIE ANN HICKMAN (NPI# 1184196883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184196883 |
| Entity Type | Individual |
| Full Name | LESLIE ANN HICKMAN |
| Credential | NP |
| Practice Address |
2601 W Main St Carbondale IL 62901-1031 |
| Mailing Address |
Po Box 3988 Carbondale IL 62902-3988 |
| Practice Telephone | 6185495361 |
| Practice Fax Number | 6183514878 |
| Mailing Telephone | 6184575200 |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2020-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209.018346 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ILLINOIS ADVANCE PRACTICE NURSE LICENSE | 209.018346 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 900 Logan College Road, Carterville, IL 62918 | 6189569202 | 6189569205 |
| 405 Rushing Dr, Herrin, IL 629483730 | 6189933300 | 6189930262 |
| 502 W Saint Louis St Ste 4, West Frankfort, IL 628961968 | 6189373400 | 6189979324 |
| 7211 Us 45 S, Carrier Mills, IL 629171305 | 6189942321 | 6189942034 |
| 117 E Clark St, Harrisburg, IL 629462702 | 6182528625 | 6183514859 |
| 3333 W Deyoung St, Marion, IL 629595884 | 6189987000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952357725 | Leslie A Hickman | Counselor | 6950 Hillsdale Court, Indianapolis, IN 46250-2040 | 2006-05-25 |
| Street Address |
2601 W MAIN ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548261399 | Jeffrey M Lehman | Allergy & Immunology | 2601 W Main St, Carbondale, IL 62901-1031 | 2005-08-02 |
| 1043846421 | Lindsay B Casolari | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2020-03-18 |
| 1194367318 | Jessica Oakley | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-10-09 |
| 1609424399 | Alexis Korbar | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-08-27 |
| 1679041685 | Kirsten Anne Beyers | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-11-07 |
| 1457834178 | Brittany Elizabeth Pierce | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-09-09 |
| 1306322110 | Katharine Johnson | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-07-15 |
| 1437699147 | Gina Gladson | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2017-02-28 |
| 1902349863 | Sarah Elizabeth Ruth Shannon | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901 | 2016-11-28 |
| 1497108971 | Jonya Lockart | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2016-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285287888 | Melissa Anne Fowler-coello | Nurse Practitioner | 305 W Jackson St Ste 100, Carbondale, IL 62901-1474 | 2019-07-23 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1093706780 | Marie A Williams | Nurse Practitioner | 30-32 N Main St, Carbondale, PA 18407-2304 | 2005-11-02 |
| 1598391484 | Jourdan Nikole Prehn | Nurse Practitioner | 211 Main St, Carbondale, KS 66414-9714 | 2020-03-23 |
| 1043846421 | Lindsay B Casolari | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2020-03-18 |
| 1871123067 | Hailee Elizabeth Bowlin | Nurse Practitioner | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-01-16 |
| 1770125817 | Jill Martin | Nurse Practitioner | 305 W Jackson St Ste 301, Carbondale, IL 62901-1474 | 2019-10-10 |
| 1194367318 | Jessica Oakley | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-10-09 |
| 1427609775 | Brandi Anderson | Nurse Practitioner | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2019-09-26 |
| 1053880781 | Heather Dawn Davis | Nurse Practitioner | 305 W Jackson St Ste 400, Carbondale, IL 62901 | 2018-11-26 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.