Provider Demographics
NPI:1831474089
Name:ZITKO, NANCY (RPH)
Entity Type:Individual
Prefix:PROF
First Name:NANCY
Middle Name:
Last Name:ZITKO
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 1:5608 ANGELS LANDING AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-2529
Mailing Address - Country:US
Mailing Address - Phone:724-263-6404
Mailing Address - Fax:
Practice Address - Street 1:5608 ANGELS LANDING AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-2529
Practice Address - Country:US
Practice Address - Phone:724-263-6404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2016-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173C00000X
PARP028242L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No173C00000XOther Service ProvidersReflexologist