Provider Demographics
NPI:1922389527
Name:BARTLETT, NICOLE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:BARTLETT
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 1:20260 ROUTE 19
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6113
Mailing Address - Country:US
Mailing Address - Phone:724-742-1040
Mailing Address - Fax:724-742-1053
Practice Address - Street 1:20260 ROUTE 19
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6113
Practice Address - Country:US
Practice Address - Phone:724-742-1040
Practice Address - Fax:724-742-1053
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441580183500000X
OH03-1-24303183500000X
NC20600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist