Eric J Nickisch, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

4991 Issued in MT

Practice address

100 Cheyenne Ave
Lame Deer, MT 59043-0070

Phone

(406) 477-4444

NPI assigned

Nov 2, 2010

Last updated

Nov 2, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1720388168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 LAKEWOOD LN",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591053666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHEYENNE AVE",
            "city": "LAME DEER",
            "state": "MT",
            "postal_code": "590430070",
            "telephone_number": "406-477-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKISCH",
        "first_name": "ERIC",
        "middle_name": "J",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "4991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Miller, LCPC, LCSW
• Philip Minnick, PHARM.D.
• Marina Faith Mitchell, RN
• Abdalla Mohamed, PHARMD
• Patricia Louise Naillon, RN
• Kristen Niederklein, BSN, RN
• Northern Cheyenne Board of Health
• Northern Cheyenne Tribe
• Northern Cheyenne Tribe (Northern Cheyenne Ambulance Service)
• Sandra Lea Olson, RN

• Pharmacist in Lame Deer, MT
• Providers in Lame Deer, MT by specialty
• Pharmacist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.