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Individual

CASEY NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1500 14TH ST W STE 150, WILLISTON, ND 58801-4080
(701) 572-7979
(701) 572-7981
Mailing address
4915 11TH AVE W APT 405, WILLISTON, ND 58801-5365
(406) 498-6927

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
PHA-PHA-LIC-62960
MT
183500000X
Pharmacist
Primary
RPH6178
ND

Other

Enumeration date
07/31/2020
Last updated
07/31/2020
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