Provider Demographics
NPI:1881299733
Name:IKONA, LUCY BELIE (RPH)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:BELIE
Last Name:IKONA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:LUCY
Other - Middle Name:BELIE
Other - Last Name:IKONA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:6300 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-4117
Mailing Address - Country:US
Mailing Address - Phone:816-444-2922
Mailing Address - Fax:816-523-1861
Practice Address - Street 1:6300 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-4117
Practice Address - Country:US
Practice Address - Phone:816-444-2922
Practice Address - Fax:816-523-1861
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044854183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist