Provider Demographics
NPI:1992013668
Name:NIXON, SHERRIL M (RPH)
Entity Type:Individual
Prefix:MR
First Name:SHERRIL
Middle Name:M
Last Name:NIXON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 LONDON BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-2239
Mailing Address - Country:US
Mailing Address - Phone:757-393-6047
Mailing Address - Fax:757-393-0426
Practice Address - Street 1:1141 LONDON BLVD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2239
Practice Address - Country:US
Practice Address - Phone:757-393-6047
Practice Address - Fax:757-393-0426
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202000882183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist