Provider Demographics
NPI:1427246677
Name:HICKOX, LYNN ELISE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:ELISE
Last Name:HICKOX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:ELISE
Other - Last Name:TEMME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2201 N BROADWELL AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-2153
Mailing Address - Country:US
Mailing Address - Phone:308-382-3660
Mailing Address - Fax:308-385-2737
Practice Address - Street 1:2201 N BROADWELL AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2153
Practice Address - Country:US
Practice Address - Phone:308-382-3660
Practice Address - Fax:308-385-2737
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12736183500000X
WY3156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist