Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO2110 | FL |
Y | 222Z00000X | Podiatrist | PO2110 | FL |
NPI | 1023056074 |
---|---|
Provider Name | Jill V Hickey |
First Address | Naples, FL 34102-6020 |
Second Address | Naples, FL 34102-6020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 13/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U19688 | (02) |