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General NPI Number Information
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NPI Number | 1871884908
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Entity Type | Individual
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Provider Name | HEATHER R WOLCOTT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/23/2011
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 16700 N MARKETPLACE BLVD
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City | NAMPA
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State | ID
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Zip | 83687-7909
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Country | US
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Telephone | 208-465-3809
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Fax |
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Provider Business Mailing Address
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Address Line | 16700 N MARKETPLACE BLVD
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City | NAMPA
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State | ID
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Zip | 83687-7909
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Country | US
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Telephone | 208-465-3809
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Fax | 208-465-3806
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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 | R2557
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License Number State | NH
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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 | PH00052420
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License Number State | WA
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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 | 051295549
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License Number State | IL
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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 | RPH0017329
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License Number State | OR
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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 | P5784
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License Number State | ID
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