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Individual

SHELLEY A HICKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
35 MEDICAL CENTER PKWY, AUGUSTA, ME 04330-8160
(207) 621-8800
(207) 621-8801
Mailing address
35 MEDICAL CENTER PKWY, AUGUSTA, ME 04330-8160
(207) 621-8800
(207) 621-8801

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
048186
ME
363L00000X
Nurse Practitioner
Primary
CNP81417
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
278880099
ME
Enumeration date
02/07/2006
Last updated
11/17/2015
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