Individual
NICOLE DEPEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 W RAILROAD ST, LONG BEACH, MS 39560-4634
(228) 575-4057
Mailing address
1596 BIRKSHIRE CT, BILOXI, MS 39532-2254
(954) 656-7183
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-100319
MS
Other
Enumeration date
08/06/2021
Last updated
08/06/2021
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