Individual
STACY CHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
HIGHWAY 491, SHIPROCK, NM 87420
(434) 227-2764
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(434) 227-2764
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202214154
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202214154
VIRGINIA PHARMACIST LICENSE
VA
Enumeration date
01/27/2016
Last updated
01/27/2016
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