Provider Demographics
NPI:1225404940
Name:STEPHENS, ALLISON MARIE (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:MARIE
Last Name:STEPHENS
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:PO BOX 1045
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601-1045
Mailing Address - Country:US
Mailing Address - Phone:660-646-7455
Mailing Address - Fax:660-646-4838
Practice Address - Street 1:601 LOCUST ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-2250
Practice Address - Country:US
Practice Address - Phone:660-646-7455
Practice Address - Fax:660-646-4838
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015028999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist