Individual
JENNIFER LEE NICKELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1320 MAPLE AVE, TERRE HAUTE, IN 47804-3129
(812) 242-2787
Mailing address
1320 MAPLE AVE, TERRE HAUTE, IN 47804-3129
(812) 242-2787
(812) 235-6876
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26022172A
IN
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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