Individual
AMANDA B. STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 STATELINE RD W, SOUTHAVEN, MS 38671-1705
(662) 342-2906
(662) 342-4495
Mailing address
35 STATELINE RD W, SOUTHAVEN, MS 38671-1705
(662) 342-2906
(662) 342-4495
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-14052
MS
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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