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Individual

MRS. JACQUELINE NICOLE NICOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
214 SAINT JAMES AVE, GOOSE CREEK, SC 29445-2974
(843) 553-3661
Mailing address
1815 TOWNE ST, JOHNS ISLAND, SC 29455-3173
(843) 446-2610
(843) 764-0305

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14238
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14238
SC BOP
SC
Enumeration date
07/16/2013
Last updated
11/26/2013
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