| Charles W Hickey, NP | |
|
1818 Amherst St, Winchester, VA 22601-2869 | |
| (540) 450-0072 | |
| (540) 450-0074 |
| Full Name | Charles W Hickey |
|---|---|
| Gender | Male |
| Speciality | Licensed Practical Nurse |
| Location | 1818 Amherst St, Winchester, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700070315 | NPI | - | NPPES |
| 1700070315 | Medicaid | VA | |
| P00657227 | Other | VA | MEDICARE RR |
| 3810009838 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 0024167461 (Virginia) | Secondary |
| 164W00000X | Licensed Practical Nurse | 0024167461 (Virginia) | Primary |
| Entity Name | Atlantic Healthcare Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912491739 PECOS PAC ID: 0345598918 Enrollment ID: O20181113002497 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles W Hickey, NP 1818 Amherst St, Winchester, VA 22601-2869 Ph: (540) 450-0072 | Charles W Hickey, NP 1818 Amherst St, Winchester, VA 22601-2869 Ph: (540) 450-0072 |
Michelle Lynn Hinkle, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 290 Front Royal Pike, Winchester, VA 22602 Phone: 540-546-3436 Fax: 540-665-5280 | |
Georgia K Franklin, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 120 Bellview Ave, Winchester, VA 22601 Phone: 540-542-0200 Fax: 540-542-0218 | |
Kathy Martin, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 120 Bellview Ave, Winchester, VA 22601 Phone: 540-542-0200 | |
Elizabeth Keefe, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 333 W Cork St, Winchester, VA 22601 Phone: 540-536-5200 | |
Lisa Dodson, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 500 Pegasus Ct, Winchester, VA 22602 Phone: 540-313-4196 Fax: 540-686-7906 | |
Sandra L Stockard, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 120 Bellview Ave, Winchester, VA 22601 Phone: 540-542-0200 | |
Autumn Fries, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 500 Pegasus Court, Winchester, VA 22602 Phone: 800-805-6989 |