Shellie Irene Hickok
Individual provider Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Anchorage, AK
NPI 1639412950 · NPPES record last updated Apr 8, 2013
Key facts
- NPI
- 1639412950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Practice address
- 6074 Doncaster Dr
Anchorage, AK 99504-3234 - Phone
- (907) 274-0060
- NPI assigned
- Apr 4, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Hickok Alh | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
6074 Doncaster Dr
Anchorage, AK 99504-3234
Mailing address
6074 Doncaster Dr
Anchorage, AK 99504-3234
Phone (907) 274-0060
Other providers in Anchorage, AK
- Kevin D Hickey
- Andrew Michael Hickman
- Kathryn Lynn Sue Hickman
- Lori M Hickman
- Bryan Hickok
- Francis Lynn Hicks
- Rachel Hicks
- Taryn Hicks
- Teresa Anne Hicks
- Zachary Wayne Hicks
All providers in Anchorage, AK · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.