Provider Demographics
NPI:1962194241
Name:ADAMS, STEPHANIE L (PHARMD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:ADAMS
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 1:5311 LANCELOT DR
Mailing Address - Street 2:
Mailing Address - City:WELDON SPRING
Mailing Address - State:MO
Mailing Address - Zip Code:63304-5742
Mailing Address - Country:US
Mailing Address - Phone:636-577-7812
Mailing Address - Fax:
Practice Address - Street 1:5311 LANCELOT DR
Practice Address - Street 2:
Practice Address - City:WELDON SPRING
Practice Address - State:MO
Practice Address - Zip Code:63304-5742
Practice Address - Country:US
Practice Address - Phone:636-577-7812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017029961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist