Provider Demographics
NPI:1437445806
Name:BROWN-SHORT, NIKKI (PHARMD)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:
Last Name:BROWN-SHORT
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 1:3150 BEL AIR MALL
Mailing Address - Street 2:T-0797
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-3206
Mailing Address - Country:US
Mailing Address - Phone:251-471-9768
Mailing Address - Fax:251-471-9776
Practice Address - Street 1:3150 BEL AIR MALL
Practice Address - Street 2:T-0797
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-3206
Practice Address - Country:US
Practice Address - Phone:251-471-9768
Practice Address - Fax:251-471-9776
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14298183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist