Susan Jane Nisson Hicks, CRNP
Nurse Practitioner, Family in Bryans Road, MD. Individual provider (NPI-1).
NPI number1164049029
StatusActive
Last updated in NPPESMar 17, 2025
Details
- NPI
- 1164049029
- Entity type
- Individual (NPI-1)
- Name
- Susan Jane Nisson Hicks
- Credential
- CRNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 26, 2020
- Certification date
- Mar 17, 2025
- Last updated
- Mar 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | R091864 | MD | Yes |
Other names
- Susan Jane Nisson Hicks (Professional Name)
Practice location
3145 Marshall Hall RdBryans Road, MD 20616-4263
Phone 301-609-5350 · Fax 301-684-2134
Mailing address
900 Elkridge Landing RdLinthicum Heights, MD 21090-2924
Phone 301-609-5350
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.