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Individual
VICKI M NUSSBAUM
Active
Individual
VICKI M NUSSBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11308
WI
183500000X
Pharmacist
29399
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11308
PHARMACIST
WI
01
—
29399
PHARMACIST
TX
Enumeration date
11/21/2006
Last updated
07/08/2007
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