Provider Demographics
NPI:1730303587
Name:STALKER, SARAH VIRGINIA (RPH)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:VIRGINIA
Last Name:STALKER
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 1:925 W BIRCH
Mailing Address - Street 2:
Mailing Address - City:GLENROCK
Mailing Address - State:WY
Mailing Address - Zip Code:82637
Mailing Address - Country:US
Mailing Address - Phone:307-436-9206
Mailing Address - Fax:
Practice Address - Street 1:925 W BIRCH
Practice Address - Street 2:
Practice Address - City:GLENROCK
Practice Address - State:WY
Practice Address - Zip Code:82637
Practice Address - Country:US
Practice Address - Phone:307-436-9206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY2518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist