Healthcare Provider Details

I. General information

NPI: 1952531568
Provider Name (Legal Business Name): STEPHANIE LYNN BALLARD PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 11/07/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 CENTRE AVE
PITTSBURGH PA
15232-1303
US

IV. Provider business mailing address

UPMC SHADYSIDE FAMILY HEALTH CENTER 5215 CENTRE AVE
PITTSBURGH PA
15232
US

V. Phone/Fax

Practice location:
  • Phone: 412-623-2287
  • Fax:
Mailing address:
  • Phone: 412-623-2287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRP442919
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: