Healthcare Provider Details

I. General information

NPI: 1154631216
Provider Name (Legal Business Name): ROBBIN ANN HICKMAN PT, DSC, PCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2951 SIENA HEIGHTS APT. 3524
HENDERSON NV
89052-3883
US

IV. Provider business mailing address

2951 SIENA HEIGHTS APT. 3524
HENDERSON NV
89052-3883
US

V. Phone/Fax

Practice location:
  • Phone: 775-742-4011
  • Fax:
Mailing address:
  • Phone: 775-742-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number0622
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: