Healthcare Provider Details

I. General information

NPI: 1679883250
Provider Name (Legal Business Name): SABRINA M KUIKEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 10/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 E. FRANKLIN BLVD
GASTONIA NC
28056
US

IV. Provider business mailing address

2500 E. FRANKLIN BLVD
GASTONIA NC
28056
US

V. Phone/Fax

Practice location:
  • Phone: 704-867-2474
  • Fax: 704-867-7746
Mailing address:
  • Phone: 704-867-2474
  • Fax: 704-867-7746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20975
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2007017628
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP440973
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: