Provider Demographics
NPI:1437749603
Name:DESIR, NATHALIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NATHALIE
Middle Name:
Last Name:DESIR
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 1:6600 OAK LEAF CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3216
Mailing Address - Country:US
Mailing Address - Phone:301-266-1587
Mailing Address - Fax:
Practice Address - Street 1:6600 OAK LEAF CT
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3216
Practice Address - Country:US
Practice Address - Phone:301-266-1587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27132183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist