Provider Demographics
NPI:1790413201
Name:STEPHENSON, LEIGH ANN (RPH)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:STEPHENSON
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 1:120 LOCUST AVE EXT STE 2
Mailing Address - Street 2:
Mailing Address - City:MT MORRIS
Mailing Address - State:PA
Mailing Address - Zip Code:15349-1355
Mailing Address - Country:US
Mailing Address - Phone:724-324-5555
Mailing Address - Fax:
Practice Address - Street 1:120 LOCUST AVE EXT STE 2
Practice Address - Street 2:
Practice Address - City:MT MORRIS
Practice Address - State:PA
Practice Address - Zip Code:15349-1355
Practice Address - Country:US
Practice Address - Phone:724-324-5555
Practice Address - Fax:724-324-5557
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044702L1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist