Stephanie Fisk Kormeier, PHARM.D.
Individual provider Active NPI Pharmacist · Weaverville, CA
NPI 1710182050 · NPPES record last updated Jul 27, 2010
Key facts
- NPI
- 1710182050
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 61855 (CA)
- Practice address
- 1131 Main St
Ste 100
Weaverville, CA 96093-0460 - Phone
- (530) 623-3250
- Fax
- (530) 623-9419
- NPI assigned
- Jun 18, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 61855 | CA | MD | General Practice Dentistry |
| IR00056068 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen G Fisk | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | IR00056068 | WA | |
| Pharmacist | 183500000X | 61855 | CA | Yes |
Addresses
Primary practice location
1131 Main St
Ste 100
Weaverville, CA 96093-0460
Mailing address
PO Box 460
Weaverville, CA 96093-0460
Phone (530) 623-3250
Other providers in Weaverville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2010. 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.