Provider Demographics
NPI:1891046843
Name:THOMPSON, STEPHANIE JEAN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:JEAN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 MILLING AVE
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-4155
Mailing Address - Country:US
Mailing Address - Phone:504-451-0611
Mailing Address - Fax:
Practice Address - Street 1:843 MILLING AVE
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-4442
Practice Address - Country:US
Practice Address - Phone:504-575-3720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-29
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist