Provider Demographics
NPI:1871503029
Name:ROTTER, STEPHANIE CHRISTINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:CHRISTINE
Last Name:ROTTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:CHRISTINE
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10651 E ST BLDG 100
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78419-5130
Mailing Address - Country:US
Mailing Address - Phone:361-961-2260
Mailing Address - Fax:361-961-3830
Practice Address - Street 1:10651 E STREET
Practice Address - Street 2:NAVAL HOSPITAL CORPUS CHRISTI
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78419-5200
Practice Address - Country:US
Practice Address - Phone:361-961-2260
Practice Address - Fax:361-961-3830
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist