Provider Demographics
NPI:1922736479
Name:LENNARD, STACY CHEYENNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:CHEYENNE
Last Name:LENNARD
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 1:12831 HIGHWAY 159
Mailing Address - Street 2:
Mailing Address - City:SHONGALOO
Mailing Address - State:LA
Mailing Address - Zip Code:71072-2801
Mailing Address - Country:US
Mailing Address - Phone:318-455-3363
Mailing Address - Fax:
Practice Address - Street 1:302 E PALMETTO AVE
Practice Address - Street 2:
Practice Address - City:PLAIN DEALING
Practice Address - State:LA
Practice Address - Zip Code:71064-4274
Practice Address - Country:US
Practice Address - Phone:318-326-4229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist