Provider Demographics
NPI:1912023862
Name:MONTANYE, NICOLE LEWIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:LEWIS
Last Name:MONTANYE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 SKI CT
Mailing Address - Street 2:
Mailing Address - City:HAVELOCK
Mailing Address - State:NC
Mailing Address - Zip Code:28532-9388
Mailing Address - Country:US
Mailing Address - Phone:252-444-3685
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL PHARMACY
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:US
Practice Address - Zip Code:28533
Practice Address - Country:US
Practice Address - Phone:252-466-0252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist