Provider Demographics
NPI:1699151035
Name:STEPHENSON, RACHAEL (PHARMD)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:STEPHENSON
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 1:132 E BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-2535
Mailing Address - Country:US
Mailing Address - Phone:607-329-7276
Mailing Address - Fax:
Practice Address - Street 1:132 E BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-2535
Practice Address - Country:US
Practice Address - Phone:781-438-9238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-08
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist