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Individual
JUANITA M NELLOS
Active
Individual
JUANITA M NELLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00003593
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440629
NABP
NM
Enumeration date
11/06/2012
Last updated
11/06/2012
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