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General NPI Number Information
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NPI Number | 1780203844
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Entity Type | Individual
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Provider Name | STEPHANIE JANE STOCK BS PHARM
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Gender | Female
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 1334 FLAMMANG DR
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City | WATERLOO
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State | IA
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Zip | 50702-4366
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Country | US
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Telephone | 319-232-3514
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Fax | 319-232-0926
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Provider Business Mailing Address
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Address Line | 1191 HICKORY RIDGE DR
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City | BUCKINGHAM
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State | IA
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Zip | 50612-9749
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Country | US
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Telephone | 641-751-3853
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Fax | 319-232-0926
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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 | 17878
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License Number State | IA
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