Provider Demographics
NPI:1386073955
Name:BLUEL, NICHOLAS EDWARD (RPH)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:EDWARD
Last Name:BLUEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14670 W 144TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-9765
Mailing Address - Country:US
Mailing Address - Phone:913-217-5684
Mailing Address - Fax:
Practice Address - Street 1:14670 W 144TH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-9765
Practice Address - Country:US
Practice Address - Phone:913-217-5684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13763183500000X
MO2004011455183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist