Provider Demographics
NPI:1285303677
Name:LINK, NICOLE SHAYLYN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:SHAYLYN
Last Name:LINK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N 41ST ST APT 208
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2371
Mailing Address - Country:US
Mailing Address - Phone:208-530-0192
Mailing Address - Fax:
Practice Address - Street 1:1615 N BELL ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-3156
Practice Address - Country:US
Practice Address - Phone:402-727-1995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist