Provider Demographics
NPI:1528284809
Name:MARSH, NICOLE MICHELLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:MICHELLE
Last Name:MARSH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:MICHELLE
Other - Last Name:GENTILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:28 SCHOOLHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-1830
Mailing Address - Country:US
Mailing Address - Phone:610-353-0284
Mailing Address - Fax:
Practice Address - Street 1:1601 CHERRY ST
Practice Address - Street 2:SUITE 1700
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1321
Practice Address - Country:US
Practice Address - Phone:215-282-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist