Provider Demographics
NPI:1760068811
Name:HICKEL, PATRICIA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:HICKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 HICUT ROAD
Mailing Address - Street 2:
Mailing Address - City:ORMA
Mailing Address - State:WV
Mailing Address - Zip Code:25268
Mailing Address - Country:US
Mailing Address - Phone:304-655-7233
Mailing Address - Fax:
Practice Address - Street 1:775 HICUT ROAD
Practice Address - Street 2:
Practice Address - City:ORMA
Practice Address - State:WV
Practice Address - Zip Code:25268
Practice Address - Country:US
Practice Address - Phone:304-655-7233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker