Provider Demographics
NPI:1720683295
Name:STEIMEL, TEGAN KYLA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TEGAN
Middle Name:KYLA
Last Name:STEIMEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TEGAN
Other - Middle Name:KYLA
Other - Last Name:BARLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:708 WASHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-9590
Mailing Address - Country:US
Mailing Address - Phone:602-531-7384
Mailing Address - Fax:
Practice Address - Street 1:504 28 1/4 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-4993
Practice Address - Country:US
Practice Address - Phone:970-341-0035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.22205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX50201OtherPHARMACIST LICENCE
COPHA.22205OtherPHARMACIST LICENCE
AZS023272OtherPHARMACIST LICENSE