Provider Demographics
NPI:1043619497
Name:HACKNEY, JULIE ANN (RPH, PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:HACKNEY
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-4012
Mailing Address - Country:US
Mailing Address - Phone:620-241-0941
Mailing Address - Fax:620-241-7104
Practice Address - Street 1:205 S CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-4012
Practice Address - Country:US
Practice Address - Phone:620-241-0941
Practice Address - Fax:620-241-7104
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist