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General NPI Number Information
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NPI Number | 1073087698
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Entity Type | Individual
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Provider Name | NADERGE NWANA RPH
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Gender | Female
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Dates
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Enumeration Date | 01/16/2019
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Last Update Date | 01/16/2019
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Provider Practice Location Address
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Address Line | 2023 LYCOMING CREEK RD
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1206
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Country | US
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Telephone | 570-327-9920
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Fax |
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Provider Business Mailing Address
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Address Line | 820 NORTHWEST DR
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City | SILVER SPRING
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State | MD
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Zip | 20901-1434
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Country | US
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Telephone | 301-232-6407
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP453064
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License Number State | PA
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