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NPI Code Detail

MEDICARE: NICHOLAS MARSH NELSON PHARM D

MEDICARE: NICHOLAS MARSH NELSON PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist15728OK

General Provider Information

NPI Number : 1558768010
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS MARSH NELSON PHARM D
Provider Business Mailing Address
First Line : 5901 NW 39TH ST
Second Line :
City : WARR ACRES
State : OK
Zip : 73122-2015
Country : US
Telephone Number : 405-495-8258
Fax Number : 405-495-8721
Provider Business Practice Location Address
First Line : 5901 NW 39TH ST
Second Line :
City : WARR ACRES
State : OK
Zip : 73122-2015
Country : US
Telephone Number : 405-495-8258
Fax Number : 405-495-8721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2014
Last Update Date : 11/28/2014

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Directions to “ NICHOLAS MARSH NELSON PHARM D” Practice Location

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