Provider Demographics
NPI:1952079337
Name:HICKMAN, CASSANDRA N (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:N
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 1:3144 YORKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-9431
Mailing Address - Country:US
Mailing Address - Phone:502-460-1909
Mailing Address - Fax:
Practice Address - Street 1:3144 YORKSHIRE DR
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-9431
Practice Address - Country:US
Practice Address - Phone:502-460-1909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY015458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist