Provider Demographics
NPI:1245720721
Name:NELKIN, HEATHER D (PHARMD, BCOP, CPP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:D
Last Name:NELKIN
Suffix:
Gender:F
Credentials:PHARMD, BCOP, CPP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:D
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 BETHESDA CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3019
Mailing Address - Country:US
Mailing Address - Phone:318-423-1527
Mailing Address - Fax:
Practice Address - Street 1:3333 SILAS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3013
Practice Address - Country:US
Practice Address - Phone:336-277-8839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC191321835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology