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General NPI Number Information
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NPI Number | 1164918488
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Entity Type | Individual
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Provider Name | STEPHANIE LEE EVANGELISTI PHARMD, MS
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Gender | Female
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 07/10/2018
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Provider Practice Location Address
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Address Line | 2596 F RD
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-1443
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Country | US
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Telephone | 970-644-3227
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Fax | 970-644-3963
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Provider Business Mailing Address
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Address Line | 2596 F RD
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-1443
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Country | US
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Telephone | 970-644-3227
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Fax | 970-644-3963
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202214193
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA.0021144
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License Number State | CO
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