Individual
STACI ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
310 W 5TH ST, BENTON, KY 42025-1102
(270) 527-3597
Mailing address
161 HUNTERS RDG, PADUCAH, KY 42001-8132
(770) 597-8445
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
015563
KY
Other
Enumeration date
04/12/2022
Last updated
04/12/2022
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