Healthcare Provider Details

I. General information

NPI: 1487587523
Provider Name (Legal Business Name): RAEGAN NEIKIRK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HEIGHTS BLVD
FLORENCE KY
41042-1415
US

IV. Provider business mailing address

1012 LOGSDON RD
LA GRANGE KY
40031-9175
US

V. Phone/Fax

Practice location:
  • Phone: 859-568-7010
  • Fax:
Mailing address:
  • Phone: 502-931-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number025771
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: