Marlene Kay Nichols, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302022938 Issued in MI

Practice address

630 W. Mitchell St
Petoskey, MI 49770

Phone

(231) 347-8282

Fax

(231) 347-4046

NPI assigned

Apr 22, 2011

Sex

Female

Sole proprietor

No

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

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303430400000",
    "number": "1487945580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 BRUBAKER RD",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709556",
            "telephone_number": "231-348-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W. MITCHELL ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "231-347-8282",
            "fax_number": "231-347-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MARLENE",
        "middle_name": "KAY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-22",
        "last_updated": "2011-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302022938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.