ROSA HICKMAN NP – NPI #1104688274
Nurse Practitioner

ROSA HICKMAN is a nurse practitioner located in BOISE, ID. NPPES recently assigned the NPI number 1104688274 to ROSA HICKMAN on January 25, 2024. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 363LF0000X from the Health Care Provider Taxonomy code set, which is classified as Nurse Practitioner specializing in Family

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ROSA HICKMAN below.

NPI Profile for

NPI Number

(about 5 weeks ago)
Entity Type
Type-1  Individual (Female)
Legal Name
Primary location
403 S 11TH ST STE 135
BOISE, ID 83702-7157
Phone: (208) 367-0700 Fax:
Mailing address
Same as primary location
Sole Proprietor
Certification Date
Jan 24, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
- Nurse Practitioner / Family (Primary)
ID 78182

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.