Provider Demographics
NPI:1144950122
Name:HICKMAN, AARON
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:HICKMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7685 167TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MOORETON
Mailing Address - State:ND
Mailing Address - Zip Code:58061-9795
Mailing Address - Country:US
Mailing Address - Phone:701-671-0089
Mailing Address - Fax:
Practice Address - Street 1:7685 167TH AVE SE
Practice Address - Street 2:
Practice Address - City:MOORETON
Practice Address - State:ND
Practice Address - Zip Code:58061-9795
Practice Address - Country:US
Practice Address - Phone:701-671-0089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty