Healthcare Provider Details

I. General information

NPI: 1962738377
Provider Name (Legal Business Name): STEPHANIE JEAN RASMUSSEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE JEAN STEPHENSON PHARMD

II. Dates (important events)

Enumeration Date: 10/20/2009
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5771 W THUNDERBIRD RD
GLENDALE AZ
85306-4635
US

IV. Provider business mailing address

5771 W THUNDERBIRD RD
GLENDALE AZ
85306-4635
US

V. Phone/Fax

Practice location:
  • Phone: 602-978-4998
  • Fax: 623-934-3692
Mailing address:
  • Phone: 602-978-4998
  • Fax: 623-934-3692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS013315
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: