Shidemantle, Stephanie Lynn

Shidemantle, Stephanie Lynn is an individual health care provider with primary practice located at 414C Mary Esther Cto Nw , Fort Walton Beach FL 32548-4060. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Shidemantle, Stephanie Lynn can be contacted via phone (850) 244-0869.

Contact Information

Primary practice address
414C Mary Esther Cto Nw Fort Walton Beach FL 32548-4060
Phone: (850) 244-0869
Fax: (850) 244-1403
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X PS50073 Florida
Pharmacy Service Providers / Pharmacist 183500000X 023927 Georgia

Profile Details

NPI number 1750666954
LBN Legal business name Shidemantle, Stephanie Lynn
Credentials PHARM.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2011
Last updated Dec 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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