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General NPI Number Information
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NPI Number | 1609284439
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Entity Type | Individual
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Provider Name | DANIEL KEITH NICKELL PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 07/24/2014
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 650 BEEBALM LN STE 220
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City | GARLAND
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State | TX
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Zip | 75040-2955
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Country | US
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Telephone | 615-687-3601
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Fax |
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Provider Business Mailing Address
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Address Line | 650 BEEBALM LN STE 220
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City | GARLAND
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State | TX
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Zip | 75040-2955
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Country | US
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Telephone | 615-687-3601
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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 | 62030
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License Number State | TX
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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 | RP452150
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License Number State | PA
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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 | RPH027986
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 019700
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 38150
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License Number State | TN
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