Provider Demographics
NPI:1962645960
Name:MCNAMEE, NICOLE (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:MCNAMEE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:WV
Mailing Address - Zip Code:25661-0220
Mailing Address - Country:US
Mailing Address - Phone:304-235-3535
Mailing Address - Fax:304-235-1258
Practice Address - Street 1:215 LOGAN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:WV
Practice Address - Zip Code:25661-3600
Practice Address - Country:US
Practice Address - Phone:304-235-3535
Practice Address - Fax:304-235-1258
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0005888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist