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General NPI Number Information
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NPI Number | 1689279788
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Entity Type | Individual
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Provider Name | NICOLE BETTY PIQUETTE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 102 E PHILIP AVE
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5537
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Country | US
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Telephone | 308-532-4303
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Fax | 308-532-4628
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Provider Business Mailing Address
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Address Line | 84 LAKEVIEW ACRES DR
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City | JOHNSON LAKE
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State | NE
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Zip | 68937
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Country | US
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Telephone | 262-832-4541
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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 | 16947
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License Number State | NE
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