Shelly R Nickerson in Gretna - Pharmacist
Shelly R Nickerson - NPI 1619166410
Shelly R Nickerson is a Pharmacist in Gretna, Nebraska. Shelly R Nickerson practices all healthcare services and medical treatments related to Pharmacist. The NPI Number for Shelly R Nickerson is 1619166410. The last update date is 2016-08-15.
Shelly R Nickerson's current location address is 22319 Ruff Rd, Gretna, Nebraska. You can contact this provider via phone number 4024719379 and fax number 4027422348. The mailing address for Shelly R Nickerson is 22319 Ruff Rd, Gretna, Nebraska. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shelly R Nickerson |
|---|---|
| Address | 22319 Ruff Rd, Gretna, Nebraska |
| Phone Number | 4024719379 |
| Fax Number | 4027422348 |
| Sole Proprietor | Y |
| Credentials | PHARMD |
NPI Number Detail
| NPI Number | 1619166410 |
|---|---|
| Provider Enumeration Date | 2007-10-17 |
| Last Updated Date | 2016-08-15 |
Provider Mailing Address Detail
| Address | 22319 Ruff Rd |
|---|---|
| City | Gretna |
| State | Nebraska (NE) |
| Post Code | 680287304 |
| Phone Number | 4024719379 |
| Fax Number | 4027422348 |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacist |
|---|---|
| Taxonomy | 183500000X |
| Licence No | 12439 |
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Definition: 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 m |
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What is the Shelly R Nickerson's 1619166410?
The Shelly R Nickerson's NPI (National Provider Identifier) Number is 1619166410. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Shelly R Nickerson located?
The Shelly R Nickerson is located at 22319 Ruff Rd, Gretna, NE 680287304.
What is Shelly R Nickerson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Shelly R Nickerson is Pharmacist, and the taxonomy classification code that categorizes this area of expertise is 183500000X.
On what date did the Shelly R Nickerson receive the assignment of its 1619166410 from the Centers for Medicare & Medicaid Services?
The Shelly R Nickerson was issued its 1619166410 by the Centers for Medicare & Medicaid Services on 2007-10-17.
As of what date were the Shelly R Nickerson's details last updated?
The information pertaining to the Shelly R Nickerson, including its address, specialty, and other details, was most recently updated on 2016-08-15.