Individual
KIMBERLE J HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
201 HOSPITAL RD, ANESTHESIA DEPARTMENT, CANTON, GA 30114-2408
(404) 851-6500
(770) 237-1124
Mailing address
PO BOX 465686, LAWRENCEVILLE, GA 30042-5686
(770) 237-1561
(770) 237-1124
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN147449
GA
Other
Enumeration date
03/14/2006
Last updated
12/16/2019
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