Provider Demographics
NPI:1164025664
Name:GULICK, NIKKI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NIKKI
Middle Name:
Last Name:GULICK
Suffix:
Gender:F
Credentials: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 SW SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-1518
Mailing Address - Country:US
Mailing Address - Phone:580-248-0300
Mailing Address - Fax:580-585-6513
Practice Address - Street 1:205 SW SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-1518
Practice Address - Country:US
Practice Address - Phone:580-248-0300
Practice Address - Fax:580-585-6513
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist