Individual
DR. DALLAS MICAH NIMSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
800 SE 4TH ST, MOORE, OK 73160-7210
(405) 794-1539
Mailing address
800 SE 4TH ST, MOORE, OK 73160-7210
(405) 794-1539
(405) 794-5804
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13774
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13774
PHARMACIST LICENSE
OK
Enumeration date
10/27/2022
Last updated
10/27/2022
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