Provider Demographics
NPI:1346650082
Name:BAUER, NOLAN JAMES (PHARM-D)
Entity Type:Individual
Prefix:DR
First Name:NOLAN
Middle Name:JAMES
Last Name:BAUER
Suffix:
Gender:M
Credentials:PHARM-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7739 BRATCHER POINT CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-5123
Mailing Address - Country:US
Mailing Address - Phone:928-279-9132
Mailing Address - Fax:
Practice Address - Street 1:7739 BRATCHER POINT CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-5123
Practice Address - Country:US
Practice Address - Phone:928-279-9132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-03
Last Update Date:2014-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18360183500000X
AZS019610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist