Healthcare Provider Details

I. General information

NPI: 1629485800
Provider Name (Legal Business Name): AMANDA JEAN FICK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2014
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E SPRUCE ST
GARDEN CITY KS
67846-5679
US

IV. Provider business mailing address

401 E SPRUCE ST
GARDEN CITY KS
67846-5679
US

V. Phone/Fax

Practice location:
  • Phone: 620-272-2152
  • Fax:
Mailing address:
  • Phone: 620-272-2152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-15571
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA19154
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: