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NPI Code Detail

MEDICARE: STEPHANIE KOWLESSAR PHARMD., BCGP

MEDICARE: STEPHANIE KOWLESSAR PHARMD., BCGP
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
1183500000XPharmacist19029NV

General Provider Information

NPI Number : 1528565223
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE KOWLESSAR PHARMD., BCGP
Provider Business Mailing Address
First Line : 1908 JAKE ANDREW AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-1372
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8656 W PATRICK LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5043
Country : US
Telephone Number : 702-777-7235
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2018
Last Update Date : 04/09/2018

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