Provider Demographics
NPI:1013236140
Name:NICOLAY, CHERYL A (RPH)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:A
Last Name:NICOLAY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:345 HAMILTON SHORES DR NE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-5711
Mailing Address - Country:US
Mailing Address - Phone:863-295-9227
Mailing Address - Fax:863-676-7937
Practice Address - Street 1:24170 US HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33859-7801
Practice Address - Country:US
Practice Address - Phone:863-676-7569
Practice Address - Fax:863-676-7937
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist