Provider Demographics
NPI:1689970121
Name:HERNDON STEPHENS, KAREN H (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:H
Last Name:HERNDON STEPHENS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60049 CHICKASAW DR
Mailing Address - Street 2:
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-4903
Mailing Address - Country:US
Mailing Address - Phone:662-257-9001
Mailing Address - Fax:
Practice Address - Street 1:60049 CHICKASAW DR
Practice Address - Street 2:
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-4903
Practice Address - Country:US
Practice Address - Phone:662-257-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE08643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist