Provider Demographics
NPI:1871992990
Name:STEINER, JENNIFER BIANCA (RPH)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BIANCA
Last Name:STEINER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:BIANCA
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2941 ZION LN
Mailing Address - Street 2:APT 104
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-5141
Mailing Address - Country:US
Mailing Address - Phone:307-234-9379
Mailing Address - Fax:307-234-9424
Practice Address - Street 1:1071 CY AVE
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601
Practice Address - Country:US
Practice Address - Phone:307-234-9379
Practice Address - Fax:307-234-9424
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3747183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY3747OtherWYOMING PHARMACY LICENSE