Provider Demographics
NPI:1861707077
Name:VARNADO, NICOLE JULIA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:JULIA
Last Name:VARNADO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:JULIA
Other - Last Name:MCNEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:480 KEMPSVILLE RD
Mailing Address - Street 2:STE 108
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3868
Mailing Address - Country:US
Mailing Address - Phone:757-216-9678
Mailing Address - Fax:757-512-5346
Practice Address - Street 1:480 KEMPSVILLE RD
Practice Address - Street 2:STE 108
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3868
Practice Address - Country:US
Practice Address - Phone:757-216-9678
Practice Address - Fax:757-512-5346
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist