Sydney Taylor Stevens, PHARMD
Individual provider Active NPI Pharmacist · Nixa, MO
NPI 1265036768 · NPPES record last updated Oct 12, 2023
Key facts
- NPI
- 1265036768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2019035646 (MO)
- Practice address
- 1824 N Hwy CC Ste a
Nixa, MO 65714-8015 - Phone
- (417) 893-3902
- NPI assigned
- Nov 24, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019035646 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Food Merchants LLC | Past |
Accepting new patients | |
| Food Merchants, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2019035646 | MO | Yes |
Addresses
Primary practice location
1824 N Hwy CC Ste a
Nixa, MO 65714-8015
Mailing address
1947 W Sunset St
Springfield, MO 65807-5903
Phone (417) 889-4000
Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.