Provider Demographics
NPI:1720380520
Name:SOMMERS, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:SOMMERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 SMITH AVE N
Mailing Address - Street 2:CHILDREN'S HOSPITAL PHARMACY
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2346
Mailing Address - Country:US
Mailing Address - Phone:651-220-6962
Mailing Address - Fax:651-220-6964
Practice Address - Street 1:345 SMITH AVE N
Practice Address - Street 2:CHILDREN'S HOSPITAL PHARMACY
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2346
Practice Address - Country:US
Practice Address - Phone:651-220-6962
Practice Address - Fax:651-220-6964
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist