Healthcare Provider Details

I. General information

NPI: 1457703845
Provider Name (Legal Business Name): NICOLE ELIZABETH GLASGOW PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE ELIZABETH TROMM

II. Dates (important events)

Enumeration Date: 07/08/2016
Last Update Date: 07/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 2ND ST NE
WASHINGTON DC
20002-8100
US

IV. Provider business mailing address

502 MATHIAS HAMMOND WAY APT 206
ANNAPOLIS MD
21401-6359
US

V. Phone/Fax

Practice location:
  • Phone: 202-346-3000
  • Fax:
Mailing address:
  • Phone: 410-703-6481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License NumberPH100002356
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License Number22572
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License Number0202215011
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: