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General NPI Number Information
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NPI Number | 1669884870
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Entity Type | Individual
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Provider Name | STEPHANIE MARIE HINES PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 03/03/2023
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Provider Practice Location Address
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Address Line | 1137 S DOBSON RD # 10
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City | MESA
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State | AZ
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Zip | 85202-3902
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Country | US
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Telephone | 480-964-1411
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Fax | 480-610-8152
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Provider Business Mailing Address
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Address Line | 8715 W HIGHWAY 71 APT 5207
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City | AUSTIN
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State | TX
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Zip | 78735-0037
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Country | US
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Telephone | 520-331-1723
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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 | S019243
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License Number State | AZ
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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 | 72086
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License Number State | TX
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