Provider Demographics
NPI:1407733173
Name:STACKHOUSE SAMPSON, SELIKA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SELIKA
Middle Name:
Last Name:STACKHOUSE SAMPSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 GROVELAND HILLS DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-8544
Mailing Address - Country:US
Mailing Address - Phone:850-339-2874
Mailing Address - Fax:
Practice Address - Street 1:1381 CROSS CREEK CIR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-3729
Practice Address - Country:US
Practice Address - Phone:850-877-6393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36281183500000X
FLPU61461835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist