Provider Demographics
NPI:1306207782
Name:TREGONING, STEPHANIE KAY (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KAY
Last Name:TREGONING
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:KAY
Other - Last Name:ROWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACY TECHNICIAN
Mailing Address - Street 1:4241 HIGHWAY 14 W
Mailing Address - Street 2:
Mailing Address - City:CHRISTOPHER
Mailing Address - State:IL
Mailing Address - Zip Code:62822-1037
Mailing Address - Country:US
Mailing Address - Phone:618-724-2401
Mailing Address - Fax:
Practice Address - Street 1:4241 HIGHWAY 14 W
Practice Address - Street 2:
Practice Address - City:CHRISTOPHER
Practice Address - State:IL
Practice Address - Zip Code:62822-1037
Practice Address - Country:US
Practice Address - Phone:618-201-9125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL049176197183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician