Provider Demographics
NPI:1255677159
Name:HEBERLING, DONNA NICOLE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:NICOLE
Last Name:HEBERLING
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:DONNA
Other - Middle Name:NICOLE
Other - Last Name:DUVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:17239 FIVE POINTS SQ
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1699
Mailing Address - Country:US
Mailing Address - Phone:302-644-7840
Mailing Address - Fax:302-644-7844
Practice Address - Street 1:17239 FIVE POINTS SQ
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1699
Practice Address - Country:US
Practice Address - Phone:302-644-7840
Practice Address - Fax:302-644-7844
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-20
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0004301183500000X
MD21122183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist