Stacie Siegel

Individual provider Active NPI Pharmacy Technician · Mineral Wells, WV

NPI 1700239100 · NPPES record last updated Jul 20, 2016

Key facts

NPI
1700239100
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacy Technician 183700000X
License
TT0011835 (WV)
Practice address
1506 Elizabeth Pike
Mineral Wells, WV 26150-8413
Phone
(814) 795-9082
NPI assigned
Jul 20, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
TT0011835WVMDPharmacy Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X TT0011835 WV Yes

Addresses

Primary practice location

1506 Elizabeth Pike
Mineral Wells, WV 26150-8413

Mailing address

1506 Elizabeth Pike
Mineral Wells, WV 26150-8413
Phone (814) 795-9082

Other providers in Mineral Wells, WV

All providers in Mineral Wells, WV · Pharmacy Technician in West Virginia

Sources for this page

Verify at the official NPI Registry.