Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Carolyn Dianne Hicks, NURSEPRACTITIONER

Individual provider Nurse Practitioner · NPI 1669045936

Carolyn Dianne Hicks, NURSEPRACTITIONER is a Nurse Practitioner in Charlotte, North Carolina. Qualified in 2020, 6 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
6
Licensed in
NC
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

200 Hawthorne Ln
Charlotte, NC 28204-2515
Phone: (704) 384-6478
Fax: (704) 384-8220
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 10439 Bunclody Dr, Charlotte, NC 28213-0216 — (336) 782-3390

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2021016239 (NC)
Nurse Practitioner Taxonomy 363L00000X · Licence 5015297 (NC)

Record details

NPI number1669045936
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedJuly 23, 2021
Last updated in NPPESMarch 26, 2026
Certification dateMarch 26, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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