Healthcare Provider Details

I. General information

NPI: 1982985354
Provider Name (Legal Business Name): STEPHANIE NIELSEN DOWELL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 COLLIER RD NW SUITE 100
ATLANTA GA
30309-1613
US

IV. Provider business mailing address

35 COLLIER RD NW SUITE 100
ATLANTA GA
30309-1613
US

V. Phone/Fax

Practice location:
  • Phone: 404-350-9772
  • Fax: 404-350-9871
Mailing address:
  • Phone: 404-350-9772
  • Fax: 404-350-9871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH025593
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: