Individual
JAVONNA STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1185
Mailing address
900 S. BOARDMAN, APT. E45, GALLUP, NM 87301
(443) 506-4771
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202210120
VA
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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