Provider Demographics
NPI:1790069177
Name:STEPHENSON, GERI (RPH)
Entity Type:Individual
Prefix:MS
First Name:GERI
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:GERI
Other - Middle Name:
Other - Last Name:HOPF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:7657 STONES RIVER CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46259-6727
Mailing Address - Country:US
Mailing Address - Phone:317-862-0650
Mailing Address - Fax:317-862-0652
Practice Address - Street 1:7657 STONES RIVER CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46259-6727
Practice Address - Country:US
Practice Address - Phone:317-862-0650
Practice Address - Fax:317-862-0652
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018956A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist