Provider Demographics
NPI:1740883461
Name:WOODWARD, STEPHANIE JANE (RPH)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JANE
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 SEMINOLE TRL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8221
Mailing Address - Country:US
Mailing Address - Phone:434-978-7990
Mailing Address - Fax:
Practice Address - Street 1:3420 SEMINOLE TRL
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8221
Practice Address - Country:US
Practice Address - Phone:434-978-7990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist