Provider Demographics
NPI:1649571324
Name:MCPHERSON, NANCY JANE (RPH)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JANE
Last Name:MCPHERSON
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 1:1416 E ROUTE 66
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-4820
Mailing Address - Country:US
Mailing Address - Phone:928-773-7960
Mailing Address - Fax:928-773-7963
Practice Address - Street 1:1416 E ROUTE 66
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-4820
Practice Address - Country:US
Practice Address - Phone:928-773-7960
Practice Address - Fax:928-773-7963
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS007795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist