1629356860 NPI number — DR. HEATHER NICHOLE MCDANIEL PHARMD

Table of content: DR. HEATHER NICHOLE MCDANIEL PHARMD (NPI 1629356860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629356860 NPI number — DR. HEATHER NICHOLE MCDANIEL PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCDANIEL
Provider First Name:
HEATHER
Provider Middle Name:
NICHOLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629356860
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7644 VOICE OF AMERICA CENTRE DR
Provider Second Line Business Mailing Address:
T-1534
Provider Business Mailing Address City Name:
WEST CHESTER
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45069-2794
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-712-1002
Provider Business Mailing Address Fax Number:
513-719-1077

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7644 VOICE OF AMERICA CENTRE DR
Provider Second Line Business Practice Location Address:
T-1534
Provider Business Practice Location Address City Name:
WEST CHESTER
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45069-2794
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-712-1002
Provider Business Practice Location Address Fax Number:
513-719-1077
Provider Enumeration Date:
07/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  03331125 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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