Healthcare Provider Details

I. General information

NPI: 1821381237
Provider Name (Legal Business Name): STEPHANIE ANN NEAL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2011
Last Update Date: 05/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 E JUBAL EARLY DR
WINCHESTER VA
22601-5179
US

IV. Provider business mailing address

645 E JUBAL EARLY DR
WINCHESTER VA
22601-5179
US

V. Phone/Fax

Practice location:
  • Phone: 540-667-1282
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202210256
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP007578
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: