Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD040294 | DC |
N | 2080P0203X | Pediatric Critical Care Doctor | MD040294 | DC |
Y | 2080P0203X | Pediatric Critical Care Doctor | ME127121 | FL |
NPI | 1245465186 |
---|---|
Provider Name | Dr. Rhiannon Hickok |
First Address | St Petersburg, FL 33701-4804 |
Second Address | St Petersburg, FL 33701-4804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2009 |
Last Update Date | 06/07/2016 |