Provider Demographics
NPI:1841339926
Name:DELGADO-JAECKS, NICOLE MARIE (PHARM D)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:DELGADO-JAECKS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3137 SENTINEL FERRY LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-7523
Mailing Address - Country:US
Mailing Address - Phone:984-296-8905
Mailing Address - Fax:
Practice Address - Street 1:2010 KILDAIRE FARM RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6614
Practice Address - Country:US
Practice Address - Phone:919-852-0749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 41878183500000X
PR5234183500000X
NC19328183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist