Provider Demographics
NPI:1821186115
Name:HYKEL-MALONE, NANCY CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:CHRISTINE
Last Name:HYKEL-MALONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10051 5TH ST N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2289
Mailing Address - Country:US
Mailing Address - Phone:727-828-2370
Mailing Address - Fax:727-568-6011
Practice Address - Street 1:1200 S PINELLAS AVE
Practice Address - Street 2:# 11
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-3728
Practice Address - Country:US
Practice Address - Phone:727-942-8900
Practice Address - Fax:727-942-8989
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033160E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA430195Medicare ID - Type Unspecified