Provider Demographics
NPI:1053640938
Name:STOLLER, ANNETTE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:STOLLER
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 1:4206 MACKENZIE CT
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-4668
Mailing Address - Country:US
Mailing Address - Phone:513-492-7860
Mailing Address - Fax:
Practice Address - Street 1:1119 WESTCHESTER WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-5040
Practice Address - Country:US
Practice Address - Phone:513-383-4338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-23
Last Update Date:2017-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032232391835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist