Provider Demographics
NPI:1255916268
Name:PAGE, STEPHANIE WEHBY (DPH)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:WEHBY
Last Name:PAGE
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 BROWNS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:TN
Mailing Address - Zip Code:38345-9666
Mailing Address - Country:US
Mailing Address - Phone:731-967-2662
Mailing Address - Fax:
Practice Address - Street 1:2060 BROWNS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:TN
Practice Address - Zip Code:38345-9666
Practice Address - Country:US
Practice Address - Phone:731-967-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist