Provider Demographics
NPI:1164307567
Name:CARNEY, STEPHANIE JILL
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JILL
Last Name:CARNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 CANDYTUFT DR
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1760
Mailing Address - Country:US
Mailing Address - Phone:267-312-8498
Mailing Address - Fax:
Practice Address - Street 1:2580 CANDYTUFT DR
Practice Address - Street 2:
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929-1760
Practice Address - Country:US
Practice Address - Phone:267-312-8498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041629L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist