Provider Demographics
NPI:1003134164
Name:MATTHEWS, STEPHANIE BROOKE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:BROOKE
Last Name:MATTHEWS
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 1:2815 SUMMERWIND DR SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-5122
Mailing Address - Country:US
Mailing Address - Phone:256-309-0156
Mailing Address - Fax:
Practice Address - Street 1:2104 AL HIGHWAY 157
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0656
Practice Address - Country:US
Practice Address - Phone:256-734-3416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist