Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. ILLYA JOHNSON-HICKLEN, RCP
ActiveMS. ILLYA JOHNSON-HICKLEN, RCP is a 2278C0205X healthcare provider located in FORT DEFIANCE, Arizona. NPI 1912619701 is currently active in the NPPES registry. Verify at CMS.
2278C0205X · FORT DEFIANCE, AZ
Registration Details
- NPI Number
- 1912619701
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 23, 2022 (3.6030884169548 yrs)
- Last Updated
- Dec 23, 2022
- License
-
RCP02003641 (TX)
Practice Information
- Address
-
CORNER OF ROUTE N12 AND, ROUTE N7FORT DEFIANCE, AZ, 865040649Browse AZ providers · Browse ZIP 86504
- Phone
- 9287298000
- Primary Specialty
-
2278C0205X
2278C0205X
Other 2278C0205X Providers in FORT DEFIANCE, AZ
| Name | Credential | NPI |
|---|---|---|
| SAMANTHA JEWEL BRYANT | RT | 1326758319 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.