Provider Demographics
NPI:1740553452
Name:STAGG, JULIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:STAGG
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 1:22862 HUFF RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:DE
Mailing Address - Zip Code:19968-2580
Mailing Address - Country:US
Mailing Address - Phone:302-644-4808
Mailing Address - Fax:
Practice Address - Street 1:22862 HUFF RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-2580
Practice Address - Country:US
Practice Address - Phone:302-644-4808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist