Individual
NICOLE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
335 W APPLEWAY AVE, COEUR D ALENE, ID 83814-9306
(208) 765-1254
Mailing address
335 W APPLEWAY AVE, COEUR D ALENE, ID 83814-9306
(208) 765-1254
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7584
ID
183500000X
Pharmacist
PHA-PHA-LIC-39487
MT
Other
Enumeration date
08/03/2016
Last updated
02/14/2020
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