Provider Demographics
NPI:1912590969
Name:HICKEY, FARRAR PELL (CRNP)
Entity type:Individual
Prefix:
First Name:FARRAR
Middle Name:PELL
Last Name:HICKEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2894 GURLEY PIKE
Mailing Address - Street 2:
Mailing Address - City:GURLEY
Mailing Address - State:AL
Mailing Address - Zip Code:35748-8971
Mailing Address - Country:US
Mailing Address - Phone:256-348-4165
Mailing Address - Fax:
Practice Address - Street 1:101 SIVLEY RD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4470
Practice Address - Country:US
Practice Address - Phone:256-265-1025
Practice Address - Fax:256-265-8303
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-081834363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care