Individual
SAMANTHA NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8681 W 135TH ST, OVERLAND PARK, KS 66223-1215
(913) 239-9168
Mailing address
8681 W 135TH ST, OVERLAND PARK, KS 66223-1215
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-117468
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-117468
PHARMACY
KS
Enumeration date
07/21/2022
Last updated
07/21/2022
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