Provider Demographics
NPI:1518277748
Name:HEBLE, ANTOINETTE M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANTOINETTE
Middle Name:M
Last Name:HEBLE
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 1:133 E CANYON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1994
Mailing Address - Country:US
Mailing Address - Phone:480-557-0908
Mailing Address - Fax:
Practice Address - Street 1:981 W ELLIOT RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-1881
Practice Address - Country:US
Practice Address - Phone:480-821-2298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS014096183500000X
CO16569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist