Provider Demographics
NPI:1043592348
Name:COATS, STEPHANIE ANN BRYANT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANN BRYANT
Last Name:COATS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:ANN
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:806 E ASH ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-3804
Mailing Address - Country:US
Mailing Address - Phone:919-734-3121
Mailing Address - Fax:919-734-5649
Practice Address - Street 1:806 E ASH ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3804
Practice Address - Country:US
Practice Address - Phone:919-734-3121
Practice Address - Fax:919-734-5649
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist