Provider Demographics
NPI:1144391848
Name:STALNAKER, SARAH ANN (CPHT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:STALNAKER
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 BAILES DR
Mailing Address - Street 2:
Mailing Address - City:NITRO
Mailing Address - State:WV
Mailing Address - Zip Code:25143-1313
Mailing Address - Country:US
Mailing Address - Phone:304-415-0676
Mailing Address - Fax:
Practice Address - Street 1:208 ROXALANA BUSINESS PARK
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-2727
Practice Address - Country:US
Practice Address - Phone:304-720-6970
Practice Address - Fax:304-720-6963
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT0005387183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician