Provider Demographics
NPI:1134683402
Name:HINES, ABIGAIL ELLEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ELLEN
Last Name:HINES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:SURLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:135 E MAXWELL ST STE 401
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2617
Mailing Address - Country:US
Mailing Address - Phone:859-323-2663
Mailing Address - Fax:
Practice Address - Street 1:135 E MAXWELL ST STE 401
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2617
Practice Address - Country:US
Practice Address - Phone:859-323-2663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY61513391835P2201X
KY017862183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care