Provider Demographics
NPI:1336989110
Name:PRIEST, HEATHER MICHELLE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MICHELLE
Last Name:PRIEST
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:PO BOX 134
Mailing Address - Street 2:44 HWY 98 EAST
Mailing Address - City:BUDE
Mailing Address - State:MS
Mailing Address - Zip Code:39630
Mailing Address - Country:US
Mailing Address - Phone:601-384-2898
Mailing Address - Fax:601-384-4326
Practice Address - Street 1:PO BOX 134
Practice Address - Street 2:44 HWY 98 EAST
Practice Address - City:BUDE
Practice Address - State:MS
Practice Address - Zip Code:39630
Practice Address - Country:US
Practice Address - Phone:601-384-2898
Practice Address - Fax:601-384-4326
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-010336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist