BRENT HICKMAN (NPI# 1932720737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932720737 |
| Entity Type | Individual |
| Full Name | BRENT HICKMAN |
| Practice Address |
30242 E 69th Pl S Broken Arrow OK 74014-5481 |
| Practice Telephone | 9186071002 |
| Mailing Telephone | 9186071002 |
| Enumeration Date | 2020-05-03 |
| Last Update Date | 2020-05-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
30242 E 69TH PL S |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74014-5481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962013110 | Team Clinic Management Partners LLC | Clinic/Center | 4300 E Gary Street, Broken Arrow, OK 74014 | 2020-08-12 |
| 1497306260 | Donna Norton | Technician | 5311 East Madison Place, Broken Arrow, OK 74014 | 2019-09-24 |
| 1588159420 | Guadalupe Luis | Social Worker | 8000 E New Orleans St, Broken Arrow, OK 74014 | 2018-06-23 |
| 1083102099 | Hailey Elaine Kimball | Specialist/Technologist | 7251 South 301st East Avenue, Broken Arrow, OH 74014 | 2018-04-25 |
| 1508365800 | Kayla Porche | Speech-Language Pathologist | 3500 E Kenosha, Broken Arrow, OK 74014 | 2018-02-02 |
| 1073973392 | Heather Miller | Behavioral Analyst | 932 Hillcrest Drive, Broken Arrow, OK 74014 | 2016-02-29 |
| 1346518677 | Julie Genet Henry | Speech-Language Pathologist | 3294 S 202nd East Ave, Broken Arrow, OK 74014 | 2011-12-01 |
| 1619265212 | Katie Leigh Elliott | Physician Assistant | 7301 E Nashville St, Broken Arrow, OK 74014 | 2011-07-16 |
| 1407084676 | Jeremiah D Wilhite | Physical Therapist | 2560 East Kenosha Street, Broken Arrow, OK 74014 | 2009-06-26 |
| 1194963041 | Longnecker Counseling and Consulting | Counselor | 7014 S. 235th E. Ave., Broken Arrow, OK 74014 | 2009-01-30 |
| Find all providers in zip 74014 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376159731 | Omar Fakhr | Student in an Organized Health Care Education/Training Program | 4213 W Greeley St, Broken Arrow, OK 74012-0612 | 2020-09-21 |
| 1588285969 | Kelson Shaun Goins | Student in an Organized Health Care Education/Training Program | 3000 S Nyssa Ave, Broken Arrow, OK 74012-7678 | 2020-04-27 |
| 1013536325 | Stephen C Klaassen | Student in an Organized Health Care Education/Training Program | 913 S Umbrella Cir, Broken Arrow, OK 74012-4555 | 2020-04-16 |
| 1750926960 | Kaitlyn Edmondson | Student in an Organized Health Care Education/Training Program | 4109 S Redwood Ave, Broken Arrow, OK 74011-1475 | 2019-11-12 |
| 1750841029 | Jacob Austin Ruzicka | Student in an Organized Health Care Education/Training Program | 7 River Ridge Rd, Broken Arrow, OK 74014-4502 | 2019-03-22 |
| 1184165557 | Andrea Kinkeade | Student in an Organized Health Care Education/Training Program | 521 E Fort Worth Dr, Broken Arrow, OK 74012-4314 | 2017-03-17 |
| 1124479324 | Amanda Nicole Knittel | Student in an Organized Health Care Education/Training Program | 1105 N 31st St, Broken Arrow, OK 74014-1886 | 2016-06-29 |
| 1841629797 | Olajumoke Beulah Adigun | Student in an Organized Health Care Education/Training Program | 1820 W Gulfport St, Broken Arrow, OK 74011-4238 | 2013-11-01 |
| 1487944104 | Lauren Kimberly Conway | Student in an Organized Health Care Education/Training Program | 2021 E Concord St, Broken Arrow, OK 74012-9637 | 2011-04-14 |
| 1639665482 | Carrol Smith | Student in an Organized Health Care Education/Training Program | 8937 S Garnett Rd, Broken Arrow, OK 74012-6018 | 2018-07-05 |
| Find all providers in BROKEN ARROW | ||||
| City | BROKEN ARROW |
| Zip Code | 74014 |
Please comment or provide details below to improve the information on BRENT HICKMAN.
| 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.