Individual
KELLIE MICHELLE HICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN BSN MSN PMHNP-BC
Contact information
Practice address
1621 N MAIN ST, BEAVER DAM, KY 42320-8963
(270) 274-9222
Mailing address
126 SPINKS DR, HARTFORD, KY 42347-9032
(270) 993-2767
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
4007496
KY
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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