Provider Demographics
NPI:1326163734
Name:FLIPPEN, NANCY LOGAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LOGAN
Last Name:FLIPPEN
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 1:11293 MANDY LN
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:VA
Mailing Address - Zip Code:23069-1715
Mailing Address - Country:US
Mailing Address - Phone:804-746-7778
Mailing Address - Fax:804-752-2154
Practice Address - Street 1:253 N WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-1623
Practice Address - Country:US
Practice Address - Phone:804-798-4576
Practice Address - Fax:804-752-2154
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005007333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy