Provider Demographics
NPI:1811591142
Name:HARGER DYKES, NICOLE JADE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:JADE
Last Name:HARGER DYKES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:JADE
Other - Last Name:HARGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:234 GOODMAN ST
Mailing Address - Street 2:ML 0740
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2364
Mailing Address - Country:US
Mailing Address - Phone:513-431-7491
Mailing Address - Fax:
Practice Address - Street 1:234 GOODMAN ST ML 0740
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219
Practice Address - Country:US
Practice Address - Phone:513-584-1338
Practice Address - Fax:513-584-1790
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-25628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist