Provider Demographics
NPI:1760086862
Name:ANDERSON, NANCY J (RPH)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:ANDERSON
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 1:18 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-2228
Mailing Address - Country:US
Mailing Address - Phone:978-664-4621
Mailing Address - Fax:978-276-1215
Practice Address - Street 1:18 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-2228
Practice Address - Country:US
Practice Address - Phone:978-664-4621
Practice Address - Fax:978-276-1215
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH20094183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist