Provider Demographics
NPI:1790961738
Name:NEHL, PHILIP JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:JAMES
Last Name:NEHL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:585 NORTHTOWN DR NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-1044
Mailing Address - Country:US
Mailing Address - Phone:763-780-7350
Mailing Address - Fax:763-784-3626
Practice Address - Street 1:585 NORTHTOWN DR NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-1044
Practice Address - Country:US
Practice Address - Phone:763-780-7350
Practice Address - Fax:763-784-3626
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-19
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1130801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist