Provider Demographics
NPI:1528491354
Name:DUIS, STACY MARIE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:MARIE
Last Name:DUIS
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 1:4118 SE COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66609-1536
Mailing Address - Country:US
Mailing Address - Phone:785-614-1132
Mailing Address - Fax:
Practice Address - Street 1:601 SW CORPORATE VW STE 210
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1245
Practice Address - Country:US
Practice Address - Phone:785-271-8000
Practice Address - Fax:785-271-8001
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-16213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist