Provider Demographics
NPI:1982218624
Name:STUTLER, STEFANIE BROOKE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:BROOKE
Last Name:STUTLER
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 1:133 ELLISON RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-2058
Mailing Address - Country:US
Mailing Address - Phone:304-543-1451
Mailing Address - Fax:
Practice Address - Street 1:201 MACCORKLE AVE
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177-1825
Practice Address - Country:US
Practice Address - Phone:304-722-3335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist