Individual
NICOLE LINDY DIVELEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
801 BELSLY BLVD, MOORHEAD, MN 56560-5055
(701) 364-6800
(701) 364-6828
Mailing address
801 BELSLY BLVD, MOORHEAD, MN 56560-5055
(701) 364-6800
(701) 364-6828
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
12727
MN
183500000X
Pharmacist
6669
SD
183500000X
Pharmacist
Primary
RPH6392
ND
Other
Enumeration date
08/20/2019
Last updated
08/15/2022
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