Provider Demographics
NPI:1952986630
Name:COGAN, NICOLE CHARLENE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:CHARLENE
Last Name:COGAN
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 1:2281 MORNING WATCH
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-4905
Mailing Address - Country:US
Mailing Address - Phone:513-266-2282
Mailing Address - Fax:
Practice Address - Street 1:2281 MORNING WATCH
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-4905
Practice Address - Country:US
Practice Address - Phone:513-266-2282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-14
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03326834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist