Provider Demographics
NPI:1437449899
Name:PAXTON, MONICA NICHOLS (RPH)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:NICHOLS
Last Name:PAXTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2330 NASH ST
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-9312
Mailing Address - Country:US
Mailing Address - Phone:304-422-4679
Mailing Address - Fax:
Practice Address - Street 1:804 PIKE ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3503
Practice Address - Country:US
Practice Address - Phone:740-376-9035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006192183500000X
OH03135340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist