Provider Demographics
NPI:1255626198
Name:GREAVES, HEATHER LEANNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:LEANNE
Last Name:GREAVES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LEANNE
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:233 CARMICHAEL WAY
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-2182
Mailing Address - Country:US
Mailing Address - Phone:757-421-6641
Mailing Address - Fax:
Practice Address - Street 1:105 GATEWAY CT
Practice Address - Street 2:APT #103
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5076
Practice Address - Country:US
Practice Address - Phone:757-548-0713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist