Individual
LISA HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
12900 W THUNDERBIRD RD, EL MIRAGE, AZ 85335-5945
(623) 583-8725
(623) 583-8775
Mailing address
12900 W THUNDERBIRD RD, EL MIRAGE, AZ 85335-5945
(623) 583-8725
(623) 583-8775
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S014944
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S014944
PHARMACIST LICENSE NUMBER
AZ
Enumeration date
07/26/2014
Last updated
07/26/2014
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