Provider Demographics
NPI:1801203971
Name:UMPHLETTE, STEPHANIE MAY (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MAY
Last Name:UMPHLETTE
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 1:5001 HOLT AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2282
Mailing Address - Country:US
Mailing Address - Phone:804-445-6784
Mailing Address - Fax:
Practice Address - Street 1:5001 HOLT AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2282
Practice Address - Country:US
Practice Address - Phone:757-951-2301
Practice Address - Fax:757-951-2300
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202213055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist