Provider Demographics
NPI:1396150363
Name:HINES-STARR, NAZAREE (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:NAZAREE
Middle Name:
Last Name:HINES-STARR
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 LANSDOWNE RD
Mailing Address - Street 2:
Mailing Address - City:HALETHORPE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-1707
Mailing Address - Country:US
Mailing Address - Phone:410-536-0555
Mailing Address - Fax:
Practice Address - Street 1:1935 LANSDOWNE RD
Practice Address - Street 2:
Practice Address - City:HALETHORPE
Practice Address - State:MD
Practice Address - Zip Code:21227-1707
Practice Address - Country:US
Practice Address - Phone:410-536-0555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18419183500000X
DEA1-0004107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist