Provider Demographics
NPI:1730598566
Name:HECK, JESSICA NICHOLE (PHARMD, PHD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:NICHOLE
Last Name:HECK
Suffix:
Gender:F
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 CLERMONT STREET (119)
Mailing Address - Street 2:DENVER VA MEDICAL CENTER- ECHCS
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220
Mailing Address - Country:US
Mailing Address - Phone:303-399-8020
Mailing Address - Fax:303-393-4624
Practice Address - Street 1:1055 CLERMONT STREET (119)
Practice Address - Street 2:DENVER VA MEDICAL CENTER- ECHCS
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:303-399-8020
Practice Address - Fax:303-393-4624
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0020363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist