Provider Demographics
NPI:1336797778
Name:OLUND, NICHOLAS XAVIER (PHARMD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:XAVIER
Last Name:OLUND
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 DAKOTA DUNES BLVD APT 209
Mailing Address - Street 2:
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5119
Mailing Address - Country:US
Mailing Address - Phone:612-360-6136
Mailing Address - Fax:
Practice Address - Street 1:100 PIERCE ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1434
Practice Address - Country:US
Practice Address - Phone:712-252-4669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23690183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist