Provider Demographics
NPI:1457772527
Name:HEATH, ELIZABETH ASHLEY (BS, PHARMD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ASHLEY
Last Name:HEATH
Suffix:
Gender:F
Credentials:BS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 CAPTAINS CV UNIT B
Mailing Address - Street 2:
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-8863
Mailing Address - Country:US
Mailing Address - Phone:252-775-0414
Mailing Address - Fax:
Practice Address - Street 1:412 CAPTAINS CV UNIT B
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-8863
Practice Address - Country:US
Practice Address - Phone:252-775-0414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist