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General NPI Number Information
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NPI Number | 1568846525
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Entity Type | Individual
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Provider Name | LAUREN DEANNA HICKMAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2015
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Last Update Date | 10/17/2018
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Provider Practice Location Address
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Address Line | 600 N. WOLFE STREET CARNEGIE 180
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City | BALTIMORE
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State | MD
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Zip | 21224
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Country | US
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Telephone | 410-502-5188
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 S HAWTHORNE RD
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3913
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Country | US
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Telephone | 844-590-6351
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 25048
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 25068
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License Number State | NC
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