Basic Information
| Provider Information | |||||||||
| NPI: | 1730598566 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HECK | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | NICHOLE | ||||||||
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| Credential: | PHARMD, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1055 CLERMONT STREET (119) | ||||||||
| Address2: | DENVER VA MEDICAL CENTER- ECHCS | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033998020 | ||||||||
| FaxNumber: | 3033934624 | ||||||||
| Practice Location | |||||||||
| Address1: | 1055 CLERMONT STREET (119) | ||||||||
| Address2: | DENVER VA MEDICAL CENTER- ECHCS | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033998020 | ||||||||
| FaxNumber: | 3033934624 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2014 | ||||||||
| LastUpdateDate: | 08/06/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PHA.0020363 | CO | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.