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General NPI Number Information
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NPI Number | 1538466990
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Entity Type | Individual
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Provider Name | REBECCA HICKMAN PA
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Gender | Female
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Dates
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Enumeration Date | 02/22/2011
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Last Update Date | 07/08/2015
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Provider Practice Location Address
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Address Line | 5555 E ARAPAHOE RD
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City | CENTENNIAL
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State | CO
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Zip | 80122-2312
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Country | US
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Telephone | 303-338-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 5555 E ARAPAHOE RD
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City | CENTENNIAL
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State | CO
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Zip | 80122-2312
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Country | US
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Telephone | 303-338-4545
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 4049
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 085003849
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License Number State | IL
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