Provider Demographics
NPI:1962075275
Name:HACKNEY, AMBER FAITH (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:FAITH
Last Name:HACKNEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1345 BARROW ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-5171
Mailing Address - Country:US
Mailing Address - Phone:325-690-5011
Mailing Address - Fax:
Practice Address - Street 1:1345 BARROW ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-5171
Practice Address - Country:US
Practice Address - Phone:325-690-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist