Healthcare Provider Details

I. General information

NPI: 1538591367
Provider Name (Legal Business Name): NICOLE ANNEMARIE PIZARRO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2013
Last Update Date: 08/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11290 W BROAD ST
GLEN ALLEN VA
23060-5815
US

IV. Provider business mailing address

506 REGENTS CROSSE LN APT 4C
HENRICO VA
23238-5594
US

V. Phone/Fax

Practice location:
  • Phone: 804-360-8912
  • Fax:
Mailing address:
  • Phone: 412-770-5176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202211572
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP447413
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: