Provider Demographics
NPI:1518757624
Name:NYMAN, CECILIA
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:NYMAN
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 1:226 AVENIDA DE AZALEAS
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-2716
Mailing Address - Country:US
Mailing Address - Phone:260-205-4322
Mailing Address - Fax:
Practice Address - Street 1:226 AVENIDA DE AZALEAS
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-2716
Practice Address - Country:US
Practice Address - Phone:260-205-4322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26030933A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist