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Individual

CANDACE D HICKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3831 PIPER ST, SUITE S450, ANCHORAGE, AK 99508-4672
(907) 258-6999
(907) 258-9470
Mailing address
3831 PIPER ST, SUITE S450, ANCHORAGE, AK 99508-4672
(907) 258-6999
(907) 258-9470

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1995
AK
363AS0400X
Surgical Physician Assistant
Primary
1995
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1570498
AK
01
1995
STATE LICENSE
AK
Enumeration date
10/21/2008
Last updated
11/15/2013
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