Provider Demographics
NPI:1184901654
Name:WHIPPLE, STEPHANIE A (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7112 205TH ST W
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-4716
Mailing Address - Country:US
Mailing Address - Phone:952-255-8261
Mailing Address - Fax:
Practice Address - Street 1:7112 205TH ST W
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-4716
Practice Address - Country:US
Practice Address - Phone:952-255-8261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11733183500000X
MN120368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist