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General NPI Number Information
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NPI Number | 1790033827
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Entity Type | Individual
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Provider Name | NICOLE MARIE SCHENK RPH
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Gender | Female
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Dates
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Enumeration Date | 08/21/2012
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Last Update Date | 08/21/2012
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Provider Practice Location Address
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Address Line | 4121 E COTTON CENTER BLVD
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City | PHOENIX
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State | AZ
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Zip | 85040-8849
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Country | US
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Telephone | 602-431-4004
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Fax |
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Provider Business Mailing Address
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Address Line | 16413 S 29TH DR
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City | PHOENIX
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State | AZ
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Zip | 85045-2282
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Country | US
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Telephone | 480-704-1340
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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 | 014074
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License Number State | AZ
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