Individual
DEBRA STEVENS NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
72 WILLOW BND, CANDLER, NC 28715-8728
(618) 889-6001
Mailing address
72 WILLOW BND, CANDLER, NC 28715-8728
(618) 889-6001
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051.289817
IL
183500000X
Pharmacist
Primary
25937
NC
183500000X
Pharmacist
8032
TN
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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