Provider Demographics
NPI:1811500556
Name:WAMBI, NANCY GLORIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:GLORIA
Last Name:WAMBI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17248 S DUPONT HWY
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19952-2479
Mailing Address - Country:US
Mailing Address - Phone:302-398-1200
Mailing Address - Fax:
Practice Address - Street 1:17248 S DUPONT HWY
Practice Address - Street 2:
Practice Address - City:HARRINGTON
Practice Address - State:DE
Practice Address - Zip Code:19952-2479
Practice Address - Country:US
Practice Address - Phone:302-398-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0015536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist