Individual
STEPHANIE MARIE CARCIONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
10307 DUPONT CIRCLE DR W STE A, FORT WAYNE, IN 46825-1633
(260) 458-3240
Mailing address
14326 WHITETAIL RUN, LEO, IN 46765-9399
(260) 403-9064
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
26022948A
IN
1835P2201X
Ambulatory Care Pharmacist
Primary
26022948A
IN
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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