Provider Demographics
NPI:1588150155
Name:KWAN, STEPHANIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:KWAN
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 1:8101 W FLAMINGO RD UNIT 1176
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-7414
Mailing Address - Country:US
Mailing Address - Phone:702-938-7544
Mailing Address - Fax:
Practice Address - Street 1:7151 W CRAIG RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6511
Practice Address - Country:US
Practice Address - Phone:702-839-9256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-07
Last Update Date:2018-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY018893183500000X
NV19479183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist