DR. HEATHER PETRIE (NPI# 1063833879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063833879 |
| Entity Type | Individual |
| Full Name | DR. HEATHER PETRIE |
| Credential | PHARMD, CPH |
| Practice Address |
4175 S Pipkin Rd Suite 208 Lakeland FL 33811-1699 |
| Practice Telephone | 8635771440 |
| Practice Fax Number | 8635771444 |
| Mailing Telephone | 8635771440 |
| Mailing Fax Number | 8635771444 |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2013-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PS48532 | FL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447605548 | Heather Socha Petrie | Nurse Practitioner | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2016-04-27 |
| Street Address |
4175 S PIPKIN RD SUITE 208 |
| City | LAKELAND |
| State | FL |
| Zip Code | 33811-1699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770904526 | Wendy Ethridge | Pharmacist | 4175 S Pipkin Rd, Suite 208, Lakeland, FL 33811-1699 | 2013-12-20 |
| 1174937585 | Leah Shaw | Pharmacist | 4175 S Pipkin Rd, Lakeland, FL 33811-1699 | 2014-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910200 | Darielle Shanette Berrian | Assisted Living Facility | 1548 Georgetown Dr, Lakeland, FL 33811 | 2020-07-23 |
| 1760991012 | Gregory Clark | Driver | 1091 Old South Dr, Lakeland, FL 33811 | 2017-09-28 |
| 1356870703 | Jeanette Michelle Edmonds | Psychologist | 4231 S. Pipkin Rd., Building 2 - Mental Health/behavioral Sciences, Lakeland, FL 33811 | 2017-06-08 |
| 1932353406 | Monique L Lisowski | Dietitian, Registered | 4231 South Pipkin Road, Lakeland, FL 33811 | 2008-11-11 |
| 1306987029 | Lifesavers Home Respiratory, Inc. | Durable Medical Equipment & Medical Supplies | 2525 Drane Field Rd, Suite 14, Lakeland, FL 33811 | 2007-02-08 |
| 1518010305 | Kirk Randall Smith | Nurse Practitioner | 1475 Airport Road, Lakeland, FL 33811 | 2007-01-18 |
| 1578568176 | Southeastern Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 3615 Century Blvd, Unit #1, Lakeland, FL 33811 | 2005-06-20 |
| 1225279318 | Affordable Transport Inc. | Non-emergency Medical Transport (VAN) | 3706 Dmg Dr, Lakeland, FL 33811-1043 | 2009-03-18 |
| 1457747875 | Candace Borders | Physical Therapy Assistant | 3225 Thoroughbred Loop N, Lakeland, FL 33811-1078 | 2015-04-13 |
| 1962849729 | Angelica Monteverde | Counselor | 3121 Filly Ln, Lakeland, FL 33811-1080 | 2013-06-03 |
| Find all providers in zip 33811 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497384085 | Rodjsyne Jones | Pharmacist | 350 Eagles Landing Dr, Lakeland, FL 33810-2999 | 2020-04-06 |
| 1487293445 | Pankaj D Patel | Pharmacist | 3656 Frentress Dr, Lakeland, FL 33812-1206 | 2019-12-22 |
| 1598324436 | Wesley Zane Hamlin | Pharmacist | 1324 Lakeland Hills Blvd # 203, Lakeland, FL 33805-4543 | 2019-06-12 |
| 1518422971 | Prime Therapeutic Consulting & Services, LLC | Pharmacist | 120 W Hickory St, Lakeland, FL 33815-4715 | 2019-02-09 |
| 1982103255 | Robert James Fournier | Pharmacist | 2025 Sylvester Rd Unit J2, Lakeland, FL 33803-3577 | 2018-02-01 |
| 1952846685 | Tara Talisea Guyher | Pharmacist | 2576 Boots Rd, Lakeland, FL 33810-5158 | 2017-01-04 |
| 1003288556 | Casey Ray Hanks | Pharmacist | 12360 Lakeland Acres Rd, Lakeland, FL 33810-1016 | 2015-10-23 |
| 1528430238 | Roshan Nathoo | Pharmacist | 7387 Us Highway 98 N, Lakeland, FL 33809-2102 | 2015-10-21 |
| 1760853832 | Cheryl Adele Minozzi | Pharmacist | 5524 Scott View Ln, Lakeland, FL 33813-3064 | 2015-10-14 |
| 1275912073 | Brent Williams | Pharmacist | 2016 Sophia Pl, Lakeland, FL 33811-2684 | 2015-05-26 |
| Find all providers in LAKELAND | ||||
Please comment or provide details below to improve the information on DR. HEATHER PETRIE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.