Provider Demographics
NPI:1619076015
Name:SCHATZLE-SPRAGUE, STEPHANIE ANNE (PHARMD, RGX, PIC,RPH)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANNE
Last Name:SCHATZLE-SPRAGUE
Suffix:
Gender:F
Credentials:PHARMD, RGX, PIC,RPH
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 86061
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70879-6061
Mailing Address - Country:US
Mailing Address - Phone:225-243-5100
Mailing Address - Fax:225-347-5350
Practice Address - Street 1:25831 WALKER SOUTH RD SUITE 1
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726
Practice Address - Country:US
Practice Address - Phone:225-243-5100
Practice Address - Fax:225-347-5350
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39781183500000X
LA15914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2207130Medicaid