Provider Demographics
NPI:1346775558
Name:NICHOLS, ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 WILLAMAN AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-2757
Mailing Address - Country:US
Mailing Address - Phone:301-467-3373
Mailing Address - Fax:
Practice Address - Street 1:5930 MAYFAIR RD
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1549
Practice Address - Country:US
Practice Address - Phone:330-499-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13329130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist