Provider Demographics
NPI:1306145446
Name:FEAGIN, NICHOLE LYNN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:LYNN
Last Name:FEAGIN
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 1:8601 DUNWOODY PL STE 750
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2519
Mailing Address - Country:US
Mailing Address - Phone:404-815-1610
Mailing Address - Fax:404-815-1609
Practice Address - Street 1:8601 DUNWOODY PL STE 750
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-2519
Practice Address - Country:US
Practice Address - Phone:404-815-1610
Practice Address - Fax:404-815-1609
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20681183500000X
MI5302047394183500000X
TN42643183500000X
MD26018183500000X
VA0202217233183500000X
TX65701183500000X
GARPH022111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist