Provider Demographics
NPI:1174563290
Name:YOST, NICHOLE MARIE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:MARIE
Last Name:YOST
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2488 STAR HILL CT
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-8561
Mailing Address - Country:US
Mailing Address - Phone:307-778-9214
Mailing Address - Fax:
Practice Address - Street 1:3702 DELL RANGE BLVD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-5453
Practice Address - Country:US
Practice Address - Phone:307-638-0192
Practice Address - Fax:307-638-5070
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY2849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist