Provider Demographics
NPI:1295280204
Name:SCHALL, HEATHER NICOLE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:NICOLE
Last Name:SCHALL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:NICOLE
Other - Last Name:ENIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4613 CHISHOLM CRK
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-6554
Mailing Address - Country:US
Mailing Address - Phone:574-250-8188
Mailing Address - Fax:
Practice Address - Street 1:1106 W WILLOW RD
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-2599
Practice Address - Country:US
Practice Address - Phone:580-234-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-19
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.022293183500000X
IN26026823A183500000X
OKR-19047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAMA.004075OtherLOUISIANA BOARD OF PHARMACY-MA LICENSE
IN26026823AOtherINDIANA BOARD OF PHARMACY-PHARMACIST LICENSE
PST.022293OtherLOUISIANA BOARD OF PHARMACY-PHARMACIST
OKR-19047OtherOKLAHOMA STATE BOARD OF PHARMACY