Provider Demographics
NPI:1942421623
Name:BELEHAR, STACY LYNN (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:LYNN
Last Name:BELEHAR
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 1:1321 7TH ST. S.
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103
Mailing Address - Country:US
Mailing Address - Phone:701-280-4497
Mailing Address - Fax:701-280-4490
Practice Address - Street 1:1717 SOUTH UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58122-0344
Practice Address - Country:US
Practice Address - Phone:701-280-4497
Practice Address - Fax:701-280-4490
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4888183500000X
MN117578183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist