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NPI Code Detail

MEDICARE: STEPHANIE CHRISTINA WATSON PHARMD

MEDICARE: STEPHANIE CHRISTINA WATSON PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist21118-40WI

General Provider Information

NPI Number : 1043990385
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE CHRISTINA WATSON PHARMD
Provider Business Mailing Address
First Line : 3109 S KINNICKINNIC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53207-2935
Country : US
Telephone Number : 414-482-3515
Fax Number :
Provider Business Practice Location Address
First Line : 3109 S KINNICKINNIC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53207-2935
Country : US
Telephone Number : 414-482-3515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2023
Last Update Date : 07/21/2023

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