Individual
KELLI R HICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11 ROCK ROW STE 210, WESTBROOK, ME 04092-4877
(207) 775-3446
(207) 879-1646
Mailing address
11 ROCK ROW STE 210, WESTBROOK, ME 04092-4877
(207) 775-3446
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
273850
MA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MD25330
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD25330
MAINE MEDICAL LICENSE
ME
Enumeration date
04/10/2015
Last updated
01/26/2026
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