Individual
GRETTA R WOODINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-3202
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-3202
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
37150
CA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
8484
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37150
CA BOARD OF PHARMACY
CA
01
—
8484
NV BOARD OF PHARMACY
NV
Enumeration date
04/16/2019
Last updated
05/21/2019
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