Provider Demographics
NPI:1881361921
Name:HOWARD, HADLEY GRACE WHICKER (PHARMD)
Entity type:Individual
Prefix:
First Name:HADLEY
Middle Name:GRACE WHICKER
Last Name:HOWARD
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 1:112 N LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-2151
Mailing Address - Country:US
Mailing Address - Phone:765-482-0180
Mailing Address - Fax:
Practice Address - Street 1:112 N LEBANON ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-2151
Practice Address - Country:US
Practice Address - Phone:765-482-0180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029393A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26029393AOtherINDIANA STATE BOARD OF PHARMACY