Provider Demographics
NPI:1730251158
Name:SCEALS, STEPHANIE KIERCE (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:KIERCE
Last Name:SCEALS
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 PHEASANT DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3021
Mailing Address - Country:US
Mailing Address - Phone:229-446-4575
Mailing Address - Fax:
Practice Address - Street 1:1315 DAWSON RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3853
Practice Address - Country:US
Practice Address - Phone:229-436-1518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022307183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist