Provider Demographics
NPI:1730523853
Name:DUNN, HEATHER LYNN (CPHT)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LYNN
Last Name:DUNN
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 VETERANS PKWY
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30204-1577
Mailing Address - Country:US
Mailing Address - Phone:770-872-3924
Mailing Address - Fax:770-872-2749
Practice Address - Street 1:597 VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30204-1577
Practice Address - Country:US
Practice Address - Phone:770-872-3924
Practice Address - Fax:770-872-2749
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHTC016815183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10004444OtherPHARMACY TECHNICIAN CERTIFICATION BOARD
GAPHTC016815OtherPHARMACY TECHNICIAN LICENSE