Provider Demographics
NPI:1194005827
Name:BARRETT, HEIDI CHRISTINE
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:CHRISTINE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10026 W WIND DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47124-9705
Mailing Address - Country:US
Mailing Address - Phone:812-923-9120
Mailing Address - Fax:
Practice Address - Street 1:1702 E SPRING ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-1652
Practice Address - Country:US
Practice Address - Phone:812-949-5015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019541A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist