| Doctor Name: | MRS. KELLY ELISABETH HICKMAN |
| NPI Number: | 1881635035 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN-276609 |
| Business Practice Address: | 9898 Borror Rd Orient, OH - 431469508 |
| Business Phone Number: | 6148779070 |
| Business Fax Number: | |
| Mailing Address: | 9898 Borror Rd, ORIENT |
| State: | OH |
| Postal Code: | 431469508 |
| Phone Number: | 6148779070 |
| Fax Number: | |
| NPI Enumeration Date: | 06/09/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | RN-276609 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |