Provider Demographics
NPI:1548866734
Name:SPENCER, STEPHANIE LYNN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LYNN
Last Name:SPENCER
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 1:4903 BROMLEY LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1234
Mailing Address - Country:US
Mailing Address - Phone:540-761-6995
Mailing Address - Fax:
Practice Address - Street 1:112 BROWNS WAY RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-9507
Practice Address - Country:US
Practice Address - Phone:540-761-6995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty