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Individual

DIANNA N KENNER-STAVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
15501 ANNAPOLIS RD, BOWIE, MD 20715-3046
(301) 383-2945
(301) 383-2948
Mailing address
HARRIS TEETER PHARMACY 324, 15501 ANNAPOLIS RD, BOWIE, MD 20715
(301) 383-2945
(301) 383-2948

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
24632
MD

Other

Enumeration date
08/30/2017
Last updated
07/21/2022
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