| NPI | 1467965087 |
|---|---|
| Former Name | KATELYNN C HICKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: 1150656) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2022-10-20 |