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General NPI Number Information
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NPI Number | 1639398860
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Entity Type | Individual
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Provider Name | STEPHANIE M RIDDLE PHARMD CPP
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3511 W MARKET ST SUITE 100
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City | GREENSBORO
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State | NC
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Zip | 27403-4443
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Country | US
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Telephone | 336-632-3505
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Fax |
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Provider Business Mailing Address
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Address Line | 5116 FOXVIEW DR
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City | PLEASANT GARDEN
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State | NC
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Zip | 27313-9572
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Country | US
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Telephone | 336-676-8856
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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 | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | 700008
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License Number State | NC
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