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General NPI Number Information
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NPI Number | 1104425511
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Entity Type | Individual
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Provider Name | NATHALIE GHNATIOS
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Gender | Female
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 417 MCALLISTER CIR
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-8749
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Country | US
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Telephone | 313-673-5132
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Fax |
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Provider Business Mailing Address
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Address Line | 417 MCALLISTER CIR
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-8749
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Country | US
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Telephone | 313-673-5132
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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 | 41833
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 24629
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 019749
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License Number State | KY
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