MEDICARE: NATHALIE HEEKIN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202205887	VA
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RP0007405	WV

General Provider Information

NPI Number	:	1154707214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHALIE HEEKIN PHARMD

Provider Business Mailing Address
First Line	:	407 HIGHLAND AVE
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-3145
Country	:	US
Telephone Number	:	804-387-1814
Fax Number	:

Provider Business Practice Location Address
First Line	:	407 HIGHLAND AVE
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-3145
Country	:	US
Telephone Number	:	804-387-1814
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2015
Last Update Date	:	06/09/2020

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