Provider Demographics
NPI:1689974180
Name:HEILIG, TERESA MARIE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:MARIE
Last Name:HEILIG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:MARIE
Other - Last Name:HEILIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:90 STERLING HWY
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7439
Mailing Address - Country:US
Mailing Address - Phone:907-226-1060
Mailing Address - Fax:907-226-1019
Practice Address - Street 1:90 STERLING HWY
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7439
Practice Address - Country:US
Practice Address - Phone:907-226-1060
Practice Address - Fax:907-226-1019
Is Sole Proprietor?:No
Enumeration Date:2010-10-30
Last Update Date:2010-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist