Individual
DR. STACY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 N 1ST ST, GRAND JUNCTION, CO 81501-2139
(970) 243-3411
(866) 491-5888
Mailing address
1401 N 1ST ST, GRAND JUNCTION, CO 81501-2139
(970) 243-3411
(866) 491-5888
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
A10003721
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHA0021987
PHARMACIST LICENSE
CO
Enumeration date
06/12/2009
Last updated
11/05/2019
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