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General NPI Number Information
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NPI Number | 1154852713
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Entity Type | Individual
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Provider Name | LISA VON HEUVEL RPH BS
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Gender | Female
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 2450 S TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-5141
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Country | US
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Telephone | 575-521-2235
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Fax |
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Provider Business Mailing Address
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Address Line | 3833 JACK NICKLAUS DR
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City | LAS CRUCES
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State | NM
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Zip | 88011-3912
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Country | US
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Telephone | 830-370-6903
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S009130
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 41948
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 42839
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP00007950
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA.0019484
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License Number State | CO
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