Provider Demographics
NPI:1023391513
Name:STEIN, BRENDA LORRAINE (RPH, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:LORRAINE
Last Name:STEIN
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 MULBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-2748
Mailing Address - Country:US
Mailing Address - Phone:563-263-5168
Mailing Address - Fax:
Practice Address - Street 1:1703 PARK AVE
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-5435
Practice Address - Country:US
Practice Address - Phone:563-263-2724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20724183500000X
IL051.291347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist