Individual provider · Type 1 NPI

Jackson Allen Kicklighter, PharmD, MHA, BCMTMS

Pharmacist · Petersburg, VA

NPI number 1255948345 Active

Practice location

20 W Bank St Ste 6
Petersburg, VA 23803-3279

Call (804) 835-5425 Map

Mailing address

3424 Midhurst Dr
Chester, VA 23831-1462

Specialties and licenses

TaxonomyCodeLicense
Pharmacist 183500000X29807 (NC)
Pharmacist Primary 183500000X0202219611 (VA)

Pharmacist: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage…

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About NPI 1255948345

Jackson Allen Kicklighter, PharmD, MHA, BCMTMS's National Provider Identifier is 1255948345, issued on Sep 23, 2020. The primary taxonomy on file is Pharmacist (183500000X), and the practice location is in Petersburg, VA. The record was last updated on Oct 21, 2022.