Healthcare Provider Details

I. General information

NPI: 1427246677
Provider Name (Legal Business Name): LYNN ELISE HICKOX PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. LYNN ELISE TEMME

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 E MISSISSIPPI AVE STE 1122
DENVER CO
80246-3048
US

IV. Provider business mailing address

2201 N BROADWELL AVE
GRAND ISLAND NE
68803-2153
US

V. Phone/Fax

Practice location:
  • Phone: 307-205-3867
  • Fax:
Mailing address:
  • Phone: 308-382-3660
  • Fax: 308-385-2737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number3156
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12736
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: