Provider Demographics
NPI:1952683856
Name:EPPS, NICOLE THOMPSON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:THOMPSON
Last Name:EPPS
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 1:1948 WHITE MARSH RD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8911
Mailing Address - Country:US
Mailing Address - Phone:757-538-1051
Mailing Address - Fax:
Practice Address - Street 1:1168 GEORGE WASHINGTON HWY N
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-4908
Practice Address - Country:US
Practice Address - Phone:757-487-6074
Practice Address - Fax:757-487-6152
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist