Provider Demographics
NPI:1962738377
Name:RASMUSSEN, STEPHANIE JEAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:JEAN
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:JEAN
Other - Last Name:STEPHENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:6710 W BETHANY HOME RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85303-4402
Mailing Address - Country:US
Mailing Address - Phone:623-934-9243
Mailing Address - Fax:623-934-3692
Practice Address - Street 1:6710 W BETHANY HOME RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85303-4402
Practice Address - Country:US
Practice Address - Phone:623-934-9243
Practice Address - Fax:623-934-3692
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS013315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist