Provider Demographics
NPI:1962794990
Name:MENTZEL, NANCY LOUISE (BSPHARM)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LOUISE
Last Name:MENTZEL
Suffix:
Gender:F
Credentials:BSPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 FALLS OF NEUSE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2468
Mailing Address - Country:US
Mailing Address - Phone:919-845-0613
Mailing Address - Fax:919-846-5369
Practice Address - Street 1:9600 FALLS OF NEUSE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2468
Practice Address - Country:US
Practice Address - Phone:919-845-0613
Practice Address - Fax:919-846-5369
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist