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General NPI Number Information
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NPI Number | 1659929057
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Entity Type | Individual
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Provider Name | HEATHER BOULET WALKER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 13323 W HARDWOOD DR
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-4938
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Country | US
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Telephone | 574-265-3637
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9194
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City | SURPRISE
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State | AZ
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Zip | 85374-0136
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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 | 26026055A
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License Number State | IN
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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 | S024327
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License Number State | AZ
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