Individual
REBECCA LYNN HAVERSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1550 E COUNTY LINE RD STE 150, INDIANAPOLIS, IN 46227-0990
(317) 534-6258
Mailing address
1550 E COUNTY LINE RD STE 150, INDIANAPOLIS, IN 46227-0990
(317) 534-6258
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26024885A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26024885A
PHARMACIST LICENSE
IN
Enumeration date
08/23/2018
Last updated
08/23/2018
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