Provider Demographics
NPI:1235262106
Name:HYLAND, NANCY JO (PHARMD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JO
Last Name:HYLAND
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:JO
Other - Last Name:LORENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2343 JADE PL NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-5421
Mailing Address - Country:US
Mailing Address - Phone:507-287-1096
Mailing Address - Fax:
Practice Address - Street 1:200 FIRST STREET SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905
Practice Address - Country:US
Practice Address - Phone:507-284-2511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116663-9183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist