Provider Demographics
NPI:1881033975
Name:MCAFEE, NOLAN JACOB (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NOLAN
Middle Name:JACOB
Last Name:MCAFEE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10105 LIMA RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46818-8657
Mailing Address - Country:US
Mailing Address - Phone:260-490-6522
Mailing Address - Fax:260-490-6524
Practice Address - Street 1:10105 LIMA RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46818-8657
Practice Address - Country:US
Practice Address - Phone:260-490-6522
Practice Address - Fax:260-490-6524
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2018-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26024772A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist