Provider Demographics
NPI:1942633052
Name:STEVENS, ADRIANNA RAE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ADRIANNA
Middle Name:RAE
Last Name:STEVENS
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 1:8300 WYOMING BLVD NE APT 922
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-2167
Mailing Address - Country:US
Mailing Address - Phone:469-396-5584
Mailing Address - Fax:
Practice Address - Street 1:9700 MENAUL BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2301
Practice Address - Country:US
Practice Address - Phone:505-299-9541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008020183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist