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General NPI Number Information
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NPI Number | 1376803452
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Entity Type | Individual
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Provider Name | STEPHANIE DENISE OWENS-GILKESSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/22/2012
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 101 BANKS STATION
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7507
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Country | US
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Telephone | 678-610-3706
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Fax | 678-610-3703
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Provider Business Mailing Address
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Address Line | 101 BANKS STA
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7507
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Country | US
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Telephone | 678-610-3706
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Fax | 678-610-3703
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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 | 019245
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License Number State | GA
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