# DR. STACY ANDERSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1710114038
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | A10003721 | DE | Yes |

## Other

- **Enumeration date:** 06/12/2009
- **Last updated:** 11/05/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | PHA0021987 | PHARMACIST LICENSE | CO |