Provider Demographics
NPI:1356511331
Name:HIBBING, DEIDRA DUNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DEIDRA
Middle Name:DUNN
Last Name:HIBBING
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 1:1005 E HICKMAN RD
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8720
Mailing Address - Country:US
Mailing Address - Phone:515-868-4051
Mailing Address - Fax:
Practice Address - Street 1:1005 E HICKMAN RD
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8720
Practice Address - Country:US
Practice Address - Phone:515-216-2762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007021858183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist