Provider Demographics
NPI:1780286641
Name:CROWLEY, STEPHANIE (RPH)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CROWLEY
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 1:7857 ALEXANDRIA PIKE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001-1099
Mailing Address - Country:US
Mailing Address - Phone:859-635-2171
Mailing Address - Fax:
Practice Address - Street 1:7857 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:KY
Practice Address - Zip Code:41001-1099
Practice Address - Country:US
Practice Address - Phone:859-635-2171
Practice Address - Fax:859-635-3831
Is Sole Proprietor?:No
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist