Provider Demographics
NPI:1871531558
Name:NICHOLS, MICHELE L (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:L
Last Name:NICHOLS
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 1:25 W SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-2027
Mailing Address - Country:US
Mailing Address - Phone:908-722-3800
Mailing Address - Fax:908-722-3850
Practice Address - Street 1:25 W SOMERSET ST
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-2027
Practice Address - Country:US
Practice Address - Phone:908-722-3800
Practice Address - Fax:908-722-3850
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02276100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist