Individual
EMILY GRACE HICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
284 CUMBERLAND AVE, PORTLAND, ME 04101-4927
(207) 874-2141
(207) 874-2164
Mailing address
180 PARK AVE, PORTLAND, ME 04102-2957
(207) 874-2141
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN52962
ME
363LP0200X
Pediatric Nurse Practitioner
Primary
CNP211428
ME
Other
Enumeration date
03/05/2021
Last updated
04/27/2025
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