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General NPI Number Information
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NPI Number | 1598377897
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN WEST PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 801 JEFFERSON ST
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City | ALGOMA
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State | WI
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Zip | 54201-1733
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Country | US
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Telephone | 920-487-2887
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Fax |
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Provider Business Mailing Address
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Address Line | 1032 EGG HARBOR RD APT 5
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City | STURGEON BAY
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State | WI
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Zip | 54235-1214
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Country | US
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Telephone | 719-313-1031
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Fax |
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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 | 20105-40
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License Number State | WI
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