Provider Demographics
NPI:1336720242
Name:WAKALA-NYENDE, NEREAH E
Entity type:Individual
Prefix:
First Name:NEREAH
Middle Name:E
Last Name:WAKALA-NYENDE
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 1:150 WALNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-5090
Mailing Address - Country:US
Mailing Address - Phone:724-438-7455
Mailing Address - Fax:724-438-7450
Practice Address - Street 1:150 WALNUT HILL RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-5090
Practice Address - Country:US
Practice Address - Phone:724-438-7455
Practice Address - Fax:724-438-7450
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2024-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist