Provider Demographics
NPI:1013557099
Name:NEIE, STEFFANY NICOLE (RPH)
Entity Type:Individual
Prefix:
First Name:STEFFANY
Middle Name:NICOLE
Last Name:NEIE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2034 S HIGHWAY 53
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-9535
Mailing Address - Country:US
Mailing Address - Phone:502-222-2028
Mailing Address - Fax:502-222-5032
Practice Address - Street 1:2034 S HIGHWAY 53
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-9535
Practice Address - Country:US
Practice Address - Phone:502-222-2028
Practice Address - Fax:502-222-5032
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020672A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist