=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144683558
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEPHANIE FOLEY PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/01/2016
-----------------------------------------------------
Last Update Date | 01/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18631 W KELLOGG DR
-----------------------------------------------------
City | GODDARD
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67052-9221
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-347-2098
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2696 SE 140 AVE
-----------------------------------------------------
City | CHENEY
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67025-8439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-772-1861
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 13087
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------