Healthcare Provider Details

I. General information

NPI: 1831002187
Provider Name (Legal Business Name): CARISSA HAWES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 NICHOLASVILLE RD
LEXINGTON KY
40503-1431
US

IV. Provider business mailing address

123 PARIS AVE
LEXINGTON KY
40505-3153
US

V. Phone/Fax

Practice location:
  • Phone: 859-260-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number025231
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: