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General NPI Number Information
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NPI Number | 1598648065
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Entity Type | Individual
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Provider Name | FAITH HEATHER ROSE STREACKER
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Gender | Female
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 2040 LAFAYETTE AVE
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City | TERRE HAUTE
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State | IN
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Zip | 47805-2920
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Country | US
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Telephone | 812-466-7536
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Fax |
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Provider Business Mailing Address
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Address Line | 225 S WATER ST APT 5
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City | CLINTON
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State | IN
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Zip | 47842-2408
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Country | US
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Telephone | 812-239-6220
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number |
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License Number State |
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