Provider Demographics
NPI:1760920698
Name:STULTZ-GRIFFEY, HEIDI CATHERINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:CATHERINE
Last Name:STULTZ-GRIFFEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:HEIDI
Other - Middle Name:CATHERINE
Other - Last Name:STULTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2450 S STATE RD
Mailing Address - Street 2:
Mailing Address - City:IONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48846-2140
Mailing Address - Country:US
Mailing Address - Phone:616-522-9175
Mailing Address - Fax:
Practice Address - Street 1:2450 S STATE RD
Practice Address - Street 2:
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-2140
Practice Address - Country:US
Practice Address - Phone:616-522-9175
Practice Address - Fax:616-522-9286
Is Sole Proprietor?:No
Enumeration Date:2017-02-12
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302044614183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist