Provider Demographics
NPI:1700474012
Name:STANKUS, BAILEY JANE (PHARMD)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:JANE
Last Name:STANKUS
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 1:4541 E SAN FRANCISCO BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1616
Mailing Address - Country:US
Mailing Address - Phone:317-430-5450
Mailing Address - Fax:
Practice Address - Street 1:6484 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5620
Practice Address - Country:US
Practice Address - Phone:520-297-8397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist