Provider Demographics
NPI:1699058594
Name:WOITAS, NICOLE LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:LYNN
Last Name:WOITAS
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 1:151 STRIKER RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16229-1739
Mailing Address - Country:US
Mailing Address - Phone:724-882-7934
Mailing Address - Fax:
Practice Address - Street 1:1200 PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:CHESWICK
Practice Address - State:PA
Practice Address - Zip Code:15024-1445
Practice Address - Country:US
Practice Address - Phone:724-274-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist