Provider Demographics
NPI:1215532122
Name:EPPLE, STEPHANIE ROSE (PHARMD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ROSE
Last Name:EPPLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10937 SASSAFRAS RD
Mailing Address - Street 2:
Mailing Address - City:TELL CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47586-9192
Mailing Address - Country:US
Mailing Address - Phone:812-719-2187
Mailing Address - Fax:
Practice Address - Street 1:225 12TH ST
Practice Address - Street 2:
Practice Address - City:TELL CITY
Practice Address - State:IN
Practice Address - Zip Code:47586-1915
Practice Address - Country:US
Practice Address - Phone:812-547-4201
Practice Address - Fax:812-547-7941
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022047A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist