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General NPI Number Information
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NPI Number | 1578848552
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Entity Type | Individual
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Provider Name | HEATHER ELAYNE WIENERS RPH
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Gender | Female
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Dates
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Enumeration Date | 10/20/2011
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 1536 E 23RD ST S
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City | INDEPENDENCE
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State | MO
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Zip | 64055-1657
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Country | US
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Telephone | 816-252-0752
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Fax | 816-252-3247
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Provider Business Mailing Address
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Address Line | 4237 NE TREMONT CT
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City | LEES SUMMIT
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State | MO
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Zip | 64064-1293
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Country | US
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Telephone |
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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 | 044742
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License Number State | MO
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