Provider Demographics
NPI:1558557439
Name:NELMS, HEATHER JACKSON (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:JACKSON
Last Name:NELMS
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 1:1530 E GLENN AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5743
Mailing Address - Country:US
Mailing Address - Phone:334-501-0726
Mailing Address - Fax:334-502-8089
Practice Address - Street 1:1530 E GLENN AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5743
Practice Address - Country:US
Practice Address - Phone:334-501-0726
Practice Address - Fax:334-502-8089
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist