=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215745484
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY SUSANN HELLMANN PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2024
-----------------------------------------------------
Last Update Date | 01/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1360 DOLWICK DR STE 200
-----------------------------------------------------
City | ERLANGER
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41018-3159
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-655-9343
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1694 BIRD RD
-----------------------------------------------------
City | INDEPENDENCE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41051-7710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-663-5446
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P2201X
-----------------------------------------------------
Taxonomy Name | Ambulatory Care Pharmacist
-----------------------------------------------------
License Number | 03236976
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1835P2201X
-----------------------------------------------------
Taxonomy Name | Ambulatory Care Pharmacist
-----------------------------------------------------
License Number | 019286
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 019286
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------