Provider Demographics
NPI:1447704499
Name:STANTON, HEATHER L (RPH, BCNSP, MBA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:STANTON
Suffix:
Gender:F
Credentials:RPH, BCNSP, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4680 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-3214
Mailing Address - Country:US
Mailing Address - Phone:610-351-2666
Mailing Address - Fax:610-351-2662
Practice Address - Street 1:4680 BROADWAY
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-3214
Practice Address - Country:US
Practice Address - Phone:610-351-2666
Practice Address - Fax:610-351-2662
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032537L183500000X, 1835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support