Provider Demographics
NPI:1952617714
Name:CREELMAN, HEATHER DENISE (RPH)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DENISE
Last Name:CREELMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CROWEL RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5248
Mailing Address - Country:US
Mailing Address - Phone:908-371-1595
Mailing Address - Fax:
Practice Address - Street 1:2645 S BROAD ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-4011
Practice Address - Country:US
Practice Address - Phone:609-888-2203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRI23515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist