Debra W Nichol, RPH

Individual provider Active NPI Pharmacist · Fayetteville, WV

NPI 1235610098 · NPPES record last updated Aug 28, 2018

Key facts

NPI
1235610098
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
RP00003666 (WV)
Practice address
217 W Maple Ave # 2
Fayetteville, WV 25840-1413
Phone
(304) 574-3991
Fax
(304) 574-3651
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP00003666WVMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP00003666 WV Yes

Addresses

Primary practice location

217 W Maple Ave # 2
Fayetteville, WV 25840-1413

Mailing address

217 W Maple Ave # 2
Fayetteville, WV 25840-1413
Phone (304) 574-3991

Other providers in Fayetteville, WV

All providers in Fayetteville, WV · Pharmacist in West Virginia

Sources for this page

Verify at the official NPI Registry.