| Brittany Lashay Hicklen, NP-C | |
| 
					3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565  | |
| (910) 945-9549 | |
| Not Available | 
| Full Name | Brittany Lashay Hicklen | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner | 
| Location | 3205 Randall Pkwy Ste 105, Wilmington, North Carolina | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1801596572 | NPI | - | NPPES | 
| 1801596572 | Other | NC | NPI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363L00000X | Nurse Practitioner | HICK-2NJDM (North Carolina) | Primary | 
| Entity Name | Lifesource Of North Carolina | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1811286156 PECOS PAC ID: 7416132428 Enrollment ID: O20110505000743  | 
| Entity Name | Signify Health Medical Associates Pllc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191001003503  | 
| Entity Name | Lifesource Prime Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1598533275 PECOS PAC ID: 7810336385 Enrollment ID: O20240416003922  | 
| Entity Name | Blue River Health Services Pllc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1720809767 PECOS PAC ID: 7012440712 Enrollment ID: O20241104000580  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Brittany Lashay Hicklen, NP-C 1209 Sweetgrass St, Knightdale, NC 27545-8162 Ph: (704) 891-6459  | Brittany Lashay Hicklen, NP-C 3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565 Ph: (910) 945-9549  | 
Travis Aaron Finkle, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2909 Market St, Wilmington, NC 28403 Phone: 910-687-4888  | |
Carolyn Jones,  Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-667-2970  | |
Valerie Lynn Wegener, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8108b Market St, Wilmington, NC 28411 Phone: 910-341-3300 Fax: 910-251-2067  | |
Mrs. Shannon Boney Mathis, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1090 Medical Center Dr, Wilmington, NC 28401 Phone: 910-662-8550 Fax: 910-343-1924  | |
Nannette B Martin, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-772-9202 Fax: 910-772-9452  | |
Elizabeth Granger, NNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-667-2970  | |
Kelly B Miller,  Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2334 41st St, Wilmington, NC 28403 Phone: 910-641-4095  |