Hickenlooper, Colin R

Hickenlooper, Colin R is an individual health care provider with primary practice located at 823 N San Francisco St Ste A , Flagstaff AZ 86001-3265. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Hickenlooper, Colin R can be contacted via phone (520) 244-0089.

Contact Information

Primary practice address
823 N San Francisco St Ste A Flagstaff AZ 86001-3265
Phone: (520) 244-0089
Fax: (520) 244-0089
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 100369 Montana
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PADA547 Alaska
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9219 Arizona

Profile Details

NPI number 1972550192
LBN Legal business name Hickenlooper, Colin R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Aug 12th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972550192 NPPES
Alaska MEDICAID 1020179

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