Provider Demographics
NPI:1992707889
Name:VOS, NICOLE DAWN (PHARMD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:DAWN
Last Name:VOS
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 1:1646 305TH STREET
Mailing Address - Street 2:
Mailing Address - City:TAMA
Mailing Address - State:IA
Mailing Address - Zip Code:52339-9634
Mailing Address - Country:US
Mailing Address - Phone:641-484-4667
Mailing Address - Fax:
Practice Address - Street 1:1646 305TH STREET
Practice Address - Street 2:
Practice Address - City:TAMA
Practice Address - State:IA
Practice Address - Zip Code:52339-9634
Practice Address - Country:US
Practice Address - Phone:641-484-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist