Provider Demographics
NPI:1730916644
Name:SANCHEZ CISNEROS, FANY MICHELLE (RPH)
Entity type:Individual
Prefix:
First Name:FANY
Middle Name:MICHELLE
Last Name:SANCHEZ CISNEROS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27855-1419
Mailing Address - Country:US
Mailing Address - Phone:252-398-3585
Mailing Address - Fax:
Practice Address - Street 1:420 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:NC
Practice Address - Zip Code:27855-1419
Practice Address - Country:US
Practice Address - Phone:252-398-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist