Provider Demographics
NPI:1801191242
Name:STEELE, MARCI LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:LYNN
Last Name:STEELE
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 1:6428 REA RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2528
Mailing Address - Country:US
Mailing Address - Phone:704-541-5713
Mailing Address - Fax:704-542-9233
Practice Address - Street 1:6428 REA RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2528
Practice Address - Country:US
Practice Address - Phone:704-541-5713
Practice Address - Fax:704-542-9233
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0609516Medicaid