Provider Demographics
NPI:1972077246
Name:HEKEL, SUZANNAH MARIE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:SUZANNAH
Middle Name:MARIE
Last Name:HEKEL
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 1:135 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELKADER
Mailing Address - State:IA
Mailing Address - Zip Code:52043-7700
Mailing Address - Country:US
Mailing Address - Phone:563-245-2530
Mailing Address - Fax:
Practice Address - Street 1:135 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ELKADER
Practice Address - State:IA
Practice Address - Zip Code:52043-7700
Practice Address - Country:US
Practice Address - Phone:563-245-2530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-19
Last Update Date:2019-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist