Individual
MS. KAITLYN ROSE HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2 MEDICAL PARK RD STE 104, COLUMBIA, SC 29203-6839
(803) 296-7864
(803) 296-9699
Mailing address
300 E MCBEE AVE STE 300, GREENVILLE, SC 29601-2899
(864) 522-8611
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5881
SC
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
03/04/2025
Last updated
07/23/2025
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