Provider Demographics
NPI:1639510944
Name:HICKMAN, KAYLA TURNER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:TURNER
Last Name:HICKMAN
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 1:4038 DAYTON BLVD
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:TN
Mailing Address - Zip Code:37415-7123
Mailing Address - Country:US
Mailing Address - Phone:423-877-2431
Mailing Address - Fax:
Practice Address - Street 1:4038 DAYTON BLVD
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:TN
Practice Address - Zip Code:37415-7123
Practice Address - Country:US
Practice Address - Phone:423-877-2431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist