Provider Demographics
NPI:1285900381
Name:LENZINGER, NICOLE (RPH)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:LENZINGER
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 1:13600 MERTON WOODS LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-9007
Mailing Address - Country:US
Mailing Address - Phone:704-231-8289
Mailing Address - Fax:
Practice Address - Street 1:2125 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5766
Practice Address - Country:US
Practice Address - Phone:704-321-7442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19289183500000X
FL35395183500000X
PARP045253L183500000X
SC011587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist