Provider Demographics
NPI:1346227535
Name:NICHOLSON, STEVEN L (RPH, PHARM D)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:L
Last Name:NICHOLSON
Suffix:
Gender:M
Credentials:RPH, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5705 62ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-5244
Mailing Address - Country:US
Mailing Address - Phone:406-771-7280
Mailing Address - Fax:
Practice Address - Street 1:5705 62ND AVE SW
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-5244
Practice Address - Country:US
Practice Address - Phone:406-771-7280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT38261835P1200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist