Provider Demographics
NPI:1902569700
Name:REINSEL, NICHOLLE ANN
Entity Type:Individual
Prefix:
First Name:NICHOLLE
Middle Name:ANN
Last Name:REINSEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 SEVEN FIELDS BLVD
Mailing Address - Street 2:
Mailing Address - City:SEVEN FIELDS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-4346
Mailing Address - Country:US
Mailing Address - Phone:724-779-3232
Mailing Address - Fax:
Practice Address - Street 1:206 SEVEN FIELDS BLVD
Practice Address - Street 2:
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-4346
Practice Address - Country:US
Practice Address - Phone:724-779-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449731183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist