Healthcare Provider Details

I. General information

NPI: 1215745484
Provider Name (Legal Business Name): EMILY SUSANN HELLMANN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY SUSANN BROEG

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 DOLWICK DR STE 200
ERLANGER KY
41018-3159
US

IV. Provider business mailing address

1694 BIRD RD
INDEPENDENCE KY
41051-7710
US

V. Phone/Fax

Practice location:
  • Phone: 859-655-9343
  • Fax:
Mailing address:
  • Phone: 859-663-5446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number019286
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number03236976
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number019286
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: