Provider Demographics
NPI:1891093845
Name:STELLING, LESLIE ERIN BLACKMON (PHARM D)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ERIN BLACKMON
Last Name:STELLING
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:ERIN
Other - Last Name:BLACKMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:319 MERCY ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-2331
Mailing Address - Country:US
Mailing Address - Phone:843-374-2825
Mailing Address - Fax:843-374-9914
Practice Address - Street 1:319 MERCY ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:SC
Practice Address - Zip Code:29560-2331
Practice Address - Country:US
Practice Address - Phone:843-374-2825
Practice Address - Fax:843-374-9914
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13161183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist