Provider Demographics
NPI:1912202144
Name:HARRAR, NANCY SUSAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:SUSAN
Last Name:HARRAR
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 1:26115 FOX CREEK COURT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062
Mailing Address - Country:US
Mailing Address - Phone:586-713-9391
Mailing Address - Fax:
Practice Address - Street 1:1167 S. CARNEY
Practice Address - Street 2:
Practice Address - City:ST. CLAIR
Practice Address - State:MI
Practice Address - Zip Code:48079
Practice Address - Country:US
Practice Address - Phone:810-329-4613
Practice Address - Fax:810-329-4513
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist