Amie Nicole Boulanger, RPh
Pharmacist in Granger, IN. Individual provider (NPI-1).
NPI number1972190254
StatusActive
Last updated in NPPESDec 22, 2020
Details
- NPI
- 1972190254
- Entity type
- Individual (NPI-1)
- Name
- Ms. Amie Nicole Boulanger
- Credential
- RPh
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 21, 2020
- Certification date
- Dec 22, 2020
- Last updated
- Dec 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 26019763A | IN | Yes |
Practice location
12850 Adams RdGranger, IN 46530-7183
Phone 574-807-8234
Mailing address
65875 Turpin RdCassopolis, MI 49031-9630
Phone 574-876-7177
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