MEDICARE: MS. STEPHANIE RENEE' ALFORD ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	3004713	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114050382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE RENEE' ALFORD ARNP

Provider Business Mailing Address
First Line	:	PO BOX 784
Second Line	:
City	:	BROWNSVILLE
State	:	KY
Zip	:	42210-0784
Country	:	US
Telephone Number	:	270-975-4050
Fax Number	:	866-809-8145

Provider Business Practice Location Address
First Line	:	210 S MAIN ST STE 101
Second Line	:
City	:	BROWNSVILLE
State	:	KY
Zip	:	42210-9001
Country	:	US
Telephone Number	:	270-975-4050
Fax Number	:	866-809-8145

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	03/12/2018

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