Individual
KRISTIN NICOLE HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 LOTHROP ST, PITTSBURGH, PA 15213-2536
(412) 647-2345
Mailing address
24 SADDLEBROOK DR, GREENSBURG, PA 15601-9788
(724) 454-3492
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MAO63693
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA063693
PENNSYLVANIA STATE MEDICAL LISCENSE
PA
Enumeration date
06/30/2022
Last updated
07/12/2022
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