Provider Demographics
NPI:1437436383
Name:NASSRI, NESRINE (RPH)
Entity Type:Individual
Prefix:
First Name:NESRINE
Middle Name:
Last Name:NASSRI
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 1:27020 ADRIANA CIR APT 201
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-6575
Mailing Address - Country:US
Mailing Address - Phone:623-218-8865
Mailing Address - Fax:
Practice Address - Street 1:27020 ADRIANA CIR APT 201
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-6575
Practice Address - Country:US
Practice Address - Phone:623-218-8865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist