Provider Demographics
NPI:1841505765
Name:HEIDEL, NANCY CAROL (RPH)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:CAROL
Last Name:HEIDEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:70 MEDICAL CENTER CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2273
Mailing Address - Country:US
Mailing Address - Phone:540-332-5946
Mailing Address - Fax:540-332-5948
Practice Address - Street 1:70 MEDICAL CENTER CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2273
Practice Address - Country:US
Practice Address - Phone:540-332-5946
Practice Address - Fax:540-332-5948
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0202010438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist