Provider Demographics
NPI:1598477515
Name:HICKMAN, ABIGAIL (PT, DPT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:HICKMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2239 W SHAWNA AVE
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-0430
Mailing Address - Country:US
Mailing Address - Phone:830-237-7717
Mailing Address - Fax:
Practice Address - Street 1:3815 N SCHREIBER WAY UNIT 103
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-8434
Practice Address - Country:US
Practice Address - Phone:830-237-7717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID5971976225100000X
TX1364541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist