Provider Demographics
NPI:1477143279
Name:STEVENSON, ALBERTA GAY (RPH)
Entity Type:Individual
Prefix:
First Name:ALBERTA
Middle Name:GAY
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ALBERTA
Other - Middle Name:GAY
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:305 WIMBLEDON CHASE APT B
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4961
Mailing Address - Country:US
Mailing Address - Phone:919-210-1254
Mailing Address - Fax:
Practice Address - Street 1:600 GRESHAM DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206905183500000X
NC09754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist