Provider Demographics
NPI:1184229072
Name:DUGGER, NATHAN ROBERT (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:ROBERT
Last Name:DUGGER
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 CONNER ST
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-3139
Mailing Address - Country:US
Mailing Address - Phone:317-773-0194
Mailing Address - Fax:
Practice Address - Street 1:2550 CONNER ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-3139
Practice Address - Country:US
Practice Address - Phone:317-773-0194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028663A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist