Provider Demographics
NPI:1235295197
Name:RHINEHART, NAN MARIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NAN
Middle Name:MARIE
Last Name:RHINEHART
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 TENNESSEE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRMOUNT
Mailing Address - State:GA
Mailing Address - Zip Code:30139-3244
Mailing Address - Country:US
Mailing Address - Phone:770-773-0653
Mailing Address - Fax:
Practice Address - Street 1:1042 RED BUD RD NE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-2081
Practice Address - Country:US
Practice Address - Phone:706-629-9139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist