Healthcare Provider Details

I. General information

NPI: 1932022761
Provider Name (Legal Business Name): STEPHANIE HESSONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W NORTHFIELD DR
BROWNSBURG IN
46112-8122
US

IV. Provider business mailing address

111 LINCOLN DR APT 102
AVON IN
46123-6422
US

V. Phone/Fax

Practice location:
  • Phone: 317-858-1415
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26032136A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: