Provider Demographics
NPI:1366737249
Name:ALLEN, HEATHER ELIZABETH (PHARMD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ELIZABETH
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 E CENTERTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-9376
Mailing Address - Country:US
Mailing Address - Phone:479-709-8941
Mailing Address - Fax:479-795-4105
Practice Address - Street 1:1800 E CENTERTON BLVD
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-9376
Practice Address - Country:US
Practice Address - Phone:479-709-8941
Practice Address - Fax:479-709-8951
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10932183500000X
AR10932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist