Provider Demographics
NPI:1407140643
Name:HANVEY, STEPHANIE A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:A
Last Name:HANVEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:A
Other - Last Name:CRUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4600 N HANLEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63134-2715
Mailing Address - Country:US
Mailing Address - Phone:866-997-3688
Mailing Address - Fax:866-470-1744
Practice Address - Street 1:4600 N HANLEY RD STE B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63134-2715
Practice Address - Country:US
Practice Address - Phone:866-997-3688
Practice Address - Fax:866-470-1744
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006025282183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist