Provider Demographics
NPI:1629364302
Name:STONE, TANYA MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:MARIE
Last Name:STONE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 S EASTERN AVE
Mailing Address - Street 2:T-1171
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-6841
Mailing Address - Country:US
Mailing Address - Phone:702-914-9715
Mailing Address - Fax:702-914-9715
Practice Address - Street 1:9725 S EASTERN AVE
Practice Address - Street 2:T-1171
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-6841
Practice Address - Country:US
Practice Address - Phone:702-914-9715
Practice Address - Fax:702-914-9715
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist