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NPI Code Detail

MEDICARE: DR. DEBORAH ANN STANLEY PHARM.D., BCPP, PHC

MEDICARE:  DR. DEBORAH ANN STANLEY  PHARM.D., BCPP, PHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1300XPsychiatric PharmacistPC00000035NM

General Provider Information

NPI Number : 1083617039
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBORAH ANN STANLEY PHARM.D., BCPP, PHC
Provider Business Mailing Address
First Line : PO BOX 93
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-0093
Country : US
Telephone Number : 505-454-5125
Fax Number : 505-454-5179
Provider Business Practice Location Address
First Line : 700 FRIEDMAN AVE
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4231
Country : US
Telephone Number : 505-454-5125
Fax Number : 505-454-5179
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 07/08/2007

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Directions to “ DR. DEBORAH ANN STANLEY PHARM.D., BCPP, PHC” Practice Location

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