| Doctor Name: | MRS. POLLY ANNE HICKMAN |
| NPI Number: | 1013284777 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP-BC |
| License Number: | CNP-01858 |
| Business Practice Address: | 2669 Scenic Dr Alamogordo, NM - 883108700 |
| Business Phone Number: | 5754465300 |
| Business Fax Number: | 5754465304 |
| Mailing Address: | 2669 Scenic Dr, ALAMOGORDO |
| State: | NM |
| Postal Code: | 883108700 |
| Phone Number: | 5754465300 |
| Fax Number: | 5754465304 |
| NPI Enumeration Date: | 11/23/2011 |
| NPI Last Update Date: | 01/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | CNP-01858 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |