Provider Demographics
NPI:1659682433
Name:NUNNERY, JEFFREY A (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:A
Last Name:NUNNERY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 E DIXON BLVD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-6832
Mailing Address - Country:US
Mailing Address - Phone:704-487-1126
Mailing Address - Fax:704-482-5506
Practice Address - Street 1:706 E DIXON BLVD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6832
Practice Address - Country:US
Practice Address - Phone:704-487-1126
Practice Address - Fax:704-482-5506
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist