Provider Demographics
NPI:1851506729
Name:STEPHEN, DEANNA KAY (RPH)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:KAY
Last Name:STEPHEN
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 1:1045 WHEELING AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-2441
Mailing Address - Country:US
Mailing Address - Phone:740-432-9301
Mailing Address - Fax:
Practice Address - Street 1:1045 WHEELING AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2441
Practice Address - Country:US
Practice Address - Phone:740-432-9301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-13
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-21411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist