Provider Demographics
NPI:1912215757
Name:STEPHENSON, LISA M (RPH)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:STEPHENSON
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 1:2103 TW ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6812
Mailing Address - Country:US
Mailing Address - Phone:919-957-2989
Mailing Address - Fax:919-957-3081
Practice Address - Street 1:2103 TW ALEXANDER DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6812
Practice Address - Country:US
Practice Address - Phone:919-957-2989
Practice Address - Fax:919-957-3081
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist