Provider Demographics
NPI:1699509364
Name:SIKES, OLIVIA STONER (RPH035081)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:STONER
Last Name:SIKES
Suffix:
Gender:F
Credentials:RPH035081
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 FREEDOM PKWY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9177
Mailing Address - Country:US
Mailing Address - Phone:770-781-6689
Mailing Address - Fax:770-781-6694
Practice Address - Street 1:2655 FREEDOM PKWY
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9177
Practice Address - Country:US
Practice Address - Phone:770-781-6689
Practice Address - Fax:770-781-6694
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0350811835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist