Provider Demographics
NPI:1528166436
Name:STEVENSON, DEBRA A (RPH PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:A
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:RPH PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-0015
Mailing Address - Country:US
Mailing Address - Phone:734-475-3843
Mailing Address - Fax:
Practice Address - Street 1:300 W WASHINGTON
Practice Address - Street 2:SUITE 110
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201
Practice Address - Country:US
Practice Address - Phone:517-784-3430
Practice Address - Fax:517-784-5822
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302020834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist