Provider Demographics
NPI:1568854701
Name:EVANS, STEPHANIE ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANN
Last Name:EVANS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:ANN
Other - Last Name:KURATNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:21400 ZEEMAN RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21661-1515
Mailing Address - Country:US
Mailing Address - Phone:410-639-9140
Mailing Address - Fax:
Practice Address - Street 1:21400 ZEEMAN RD
Practice Address - Street 2:
Practice Address - City:ROCK HALL
Practice Address - State:MD
Practice Address - Zip Code:21661-1515
Practice Address - Country:US
Practice Address - Phone:410-639-9140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-25
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449017183500000X
DEA1-0004623183500000X
MD27893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist