Healthcare Provider Details

I. General information

NPI: 1326563552
Provider Name (Legal Business Name): JANAE CRYSTAL HEUCHERT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 DIVISION AVE S
CAVALIER ND
58220-4005
US

IV. Provider business mailing address

301 MOUNTAIN ST E
CAVALIER ND
58220-4015
US

V. Phone/Fax

Practice location:
  • Phone: 701-265-4744
  • Fax:
Mailing address:
  • Phone: 701-265-6257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH5951
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: