Hickle, Kelli R
Hickle, Kelli R is an individual health care provider with primary practice located at 244 Western Ave # 100 , South Portland ME 04106-2496. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery is her primary health care specialty. Hickle, Kelli R can be contacted via phone (207) 775-3446.Contact Information
Primary practice address
244 Western Ave # 100
South Portland ME 04106-2496
Phone: (207) 775-3446
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 273850 | Massachusetts |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | MD25330 | Maine |
Profile Details
| NPI number | 1013303544 |
|---|---|
| LBN Legal business name | Hickle, Kelli R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2015 |
| Last updated | Apr 10th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013303544 | NPPES |
| Maine | Other | MD25330 | MAINE MEDICAL LICENSE |
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