Provider Demographics
NPI:1770860363
Name:LYNCH, STEPHANIE A (RPH)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:A
Last Name:LYNCH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4001 E 120TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-1716
Mailing Address - Country:US
Mailing Address - Phone:303-451-5562
Mailing Address - Fax:303-451-1682
Practice Address - Street 1:4401 WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-3302
Practice Address - Country:US
Practice Address - Phone:303-463-7719
Practice Address - Fax:303-463-7765
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO15090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist