Provider Demographics
NPI:1245459288
Name:HEAD, STEPHANIE ANN (RPH)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ANN
Last Name:HEAD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:5620 N DELTA AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2279
Mailing Address - Country:US
Mailing Address - Phone:816-452-7711
Mailing Address - Fax:816-452-9329
Practice Address - Street 1:7117 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64119-1123
Practice Address - Country:US
Practice Address - Phone:816-452-7711
Practice Address - Fax:816-452-9329
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO043868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist