NPI 1003141631

Jackie Lee Stiltner

Practitioner Pharmacist McCarr, KY

Practice location

Address: 11349 State Hwy 1056 Buskirk Plaza Rite Aid, McCarr, KY 41544
Phone: (606) 427-9007
Mailing address: 13685 Grapevine Rd, Phyllis, KY 41554-8504

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 014680 (KY)

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Registry record

NPI: 1003141631
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Oct 2009
Record last updated: 15 Oct 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.