Provider Demographics
NPI:1952750747
Name:MCDONALD, STEPHANIE ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:MCDONALD
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 1:100 PIONEERS MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MEEKER
Mailing Address - State:CO
Mailing Address - Zip Code:81641-3181
Mailing Address - Country:US
Mailing Address - Phone:970-878-9797
Mailing Address - Fax:888-810-1897
Practice Address - Street 1:100 PIONEERS MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MEEKER
Practice Address - State:CO
Practice Address - Zip Code:81641-3181
Practice Address - Country:US
Practice Address - Phone:970-878-9797
Practice Address - Fax:888-810-1897
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3868183500000X
NE15212183500000X
MT35730183500000X
COPHA00212531835P0018X
CO0021253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist