Individual
MS. TAMARA LEIGH NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
31100 CORTEZ BLVD, BROOKSVILLE, FL 34602-7548
(352) 754-5154
(352) 754-5215
Mailing address
5071 CHAMBER CT, SPRING HILL, FL 34609-1608
(352) 688-2461
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
240101021141513
FL
Other
Enumeration date
04/19/2007
Last updated
07/09/2007
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