Provider Demographics
NPI:1720318017
Name:NUNLEY-SMITH, REGINA LOUISE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:LOUISE
Last Name:NUNLEY-SMITH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:REGINA
Other - Middle Name:
Other - Last Name:NUNLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:2243 E GRANITE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-4317
Mailing Address - Country:US
Mailing Address - Phone:520-990-8552
Mailing Address - Fax:
Practice Address - Street 1:2243 E GRANITE VIEW DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-4317
Practice Address - Country:US
Practice Address - Phone:520-990-8552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-292470183500000X
AZS016087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist