MEDICARE: DR. ROBBIN ANN HICKMAN PT, DSC, PCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	0622	NV

General Provider Information

NPI Number	:	1154631216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBBIN ANN HICKMAN PT, DSC, PCS

Provider Business Mailing Address
First Line	:	2951 SIENA HEIGHTS
Second Line	:	APT. 3524
City	:	HENDERSON
State	:	NV
Zip	:	89052-3883
Country	:	US
Telephone Number	:	775-742-4011
Fax Number	:

Provider Business Practice Location Address
First Line	:	2951 SIENA HEIGHTS
Second Line	:	APT. 3524
City	:	HENDERSON
State	:	NV
Zip	:	89052-3883
Country	:	US
Telephone Number	:	775-742-4011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2010
Last Update Date	:	10/07/2010

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