Nancy Kickliter, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

9392 Issued in AL

Practice address

404 Beach Island Trce
Dadeville, AL 36853-4615

Phone

(334) 524-2573

NPI assigned

Oct 6, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1124625835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 BEACH ISLAND TRCE",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368534615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 BEACH ISLAND TRCE",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368534615",
            "telephone_number": "334-524-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICKLITER",
        "first_name": "NANCY",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "9392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Dadeville",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "404 Beach Island Trce",
            "city": "Dadeville",
            "state": "AL",
            "country_code": "US",
            "postal_code": "368534615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Dadeville, AL
• Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.