Provider Demographics
NPI:1164663456
Name:CHOPSKI, NICOLE L (PHARMD, CGP, ANP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:L
Last Name:CHOPSKI
Suffix:
Gender:F
Credentials:PHARMD, CGP, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3005
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83206-3005
Mailing Address - Country:US
Mailing Address - Phone:208-339-0420
Mailing Address - Fax:208-233-6769
Practice Address - Street 1:1200 HOSPITAL WAY
Practice Address - Street 2:ATTN: PHARMACY
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-2708
Practice Address - Country:US
Practice Address - Phone:208-339-0420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP52471835G0303X, 1835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835N0905XPharmacy Service ProvidersPharmacistNuclear