Provider Demographics
NPI:1356890321
Name:KLUGHERS, NICOLE B (ND, PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:B
Last Name:KLUGHERS
Suffix:
Gender:F
Credentials:ND, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 BLACK ROCK TPKE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-4742
Mailing Address - Country:US
Mailing Address - Phone:631-702-0805
Mailing Address - Fax:
Practice Address - Street 1:1845 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1347
Practice Address - Country:US
Practice Address - Phone:234-222-8362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT571175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath