Healthcare Provider Details

I. General information

NPI: 1659754604
Provider Name (Legal Business Name): STEPHANIE WALLEN ULMER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 RIVER RIDGE DR
ASHEVILLE NC
28803-1299
US

IV. Provider business mailing address

2 MEADOW BROOK DR
FLETCHER NC
28732-9101
US

V. Phone/Fax

Practice location:
  • Phone: 828-298-6350
  • Fax: 828-299-3982
Mailing address:
  • Phone: 828-702-1539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16471
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: