Provider Demographics
NPI:1467217323
Name:MULLINS, HEATHER (PHARMD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MULLINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 EDGEHILL LN
Mailing Address - Street 2:
Mailing Address - City:MACCLESFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27852-9103
Mailing Address - Country:US
Mailing Address - Phone:252-813-9046
Mailing Address - Fax:
Practice Address - Street 1:1004 MAIN ST
Practice Address - Street 2:
Practice Address - City:SCOTLAND NECK
Practice Address - State:NC
Practice Address - Zip Code:27874-1232
Practice Address - Country:US
Practice Address - Phone:252-826-4137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29601183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist