Provider Demographics
NPI:1851493001
Name:BOATRIGHT, NICOLE CHER (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:CHER
Last Name:BOATRIGHT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:CHER
Other - Last Name:CASSELBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:P.O. BOX 4000
Mailing Address - Street 2:JAMES H. QUILLEN VA MEDICAL CENTER
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:TN
Mailing Address - Zip Code:37684
Mailing Address - Country:US
Mailing Address - Phone:423-926-1171
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 160 DEPARTMENT OF PHARMACY
Practice Address - Street 2:JAMES H. QUILLEN VA MEDICAL CENTER
Practice Address - City:MOUNTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031834183500000X
NC19271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist