Provider Demographics
NPI:1912233552
Name:RAILING, NACOLE MARIE
Entity type:Individual
Prefix:DR
First Name:NACOLE
Middle Name:MARIE
Last Name:RAILING
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 1:4001 FM 2181
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76210-4212
Mailing Address - Country:US
Mailing Address - Phone:940-498-0045
Mailing Address - Fax:940-498-0073
Practice Address - Street 1:4001 FM 2181
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-4212
Practice Address - Country:US
Practice Address - Phone:940-498-0045
Practice Address - Fax:940-498-0073
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-01
Last Update Date:2009-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist