Provider Demographics
NPI:1669986436
Name:DICKMAN, ANNETTE LYNN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:LYNN
Last Name:DICKMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9460 GILES RD
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-3064
Mailing Address - Country:US
Mailing Address - Phone:402-513-4214
Mailing Address - Fax:402-513-4208
Practice Address - Street 1:9460 GILES RD
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-3064
Practice Address - Country:US
Practice Address - Phone:402-513-4214
Practice Address - Fax:402-513-4208
Is Sole Proprietor?:No
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist