1871717181 NPI number — DR. JESSICA MCCREADY HINCKLEY PHARM.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871717181 NPI number — DR. JESSICA MCCREADY HINCKLEY PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HINCKLEY
Provider First Name:
JESSICA
Provider Middle Name:
MCCREADY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCCREADY
Provider Other First Name:
JESSICA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1871717181
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
222 TONGASS DR
Provider Second Line Business Mailing Address:
PHARMACY DEPARTMENT
Provider Business Mailing Address City Name:
SITKA
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99835-9416
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-966-2411
Provider Business Mailing Address Fax Number:
907-966-8450

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 TONGASS DR
Provider Second Line Business Practice Location Address:
PHARMACY DEPARTMENT
Provider Business Practice Location Address City Name:
SITKA
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99835-9416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-966-2411
Provider Business Practice Location Address Fax Number:
907-966-8450
Provider Enumeration Date:
04/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  1524 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: 4974 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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