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Contact Information

MOLLY K HICKEY, PAC
2355 HWY 36 W.
STE. 100
ROSEVILLE, MN55113
 Phone: 651-292-2000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MOLLY K HICKEY · (Female)

NPI Number 1598107484
Status Active
Credentials PAC
Entity Individual
Enumeration date 07/22/2013
Last updated 03/13/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 11577
  • WI License # 3406-23
Hospital affiliation(s)
  • FAIRVIEW LAKES MEDICAL CENTER - (Acute Care)
    5200 FAIRVIEW BOULEVARD
    WYOMING, MN 55092
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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