Provider Demographics
NPI:1912212325
Name:NAKHLA, NERMIN
Entity Type:Individual
Prefix:
First Name:NERMIN
Middle Name:
Last Name:NAKHLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5737 SARAH DR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6465
Mailing Address - Country:US
Mailing Address - Phone:862-220-7616
Mailing Address - Fax:
Practice Address - Street 1:6016 SHALLOWFORD RD
Practice Address - Street 2:SUITE 1300
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7225
Practice Address - Country:US
Practice Address - Phone:423-899-3690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist