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Contact Information

ILLYA JOHNSON HICKLEN, RCP
CORNER OF ROUTE N12 AND, ROUTE N7
FORT DEFIANCE, AZ86504-0649
 Phone: 928-729-8000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Critical Care

2278C0205X
Indicates primary specialty

NPI Profile & details for ILLYA JOHNSON HICKLEN · (Female)

NPI # 1912619701
Status Active
Credentials RCP
Entity Individual
Enumeration date 12/23/2022
Last updated 12/23/2022 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • TX License # RCP02003641
Hospital affiliation(s) Not Available
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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