MEDICARE: MISS STEPHANIE MICHELE MILTON STNA/MA

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	376K00000X	Nurse's Aide	400715680208	OH

General Provider Information

NPI Number	:	1205270774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS STEPHANIE MICHELE MILTON STNA/MA

Provider Business Mailing Address
First Line	:	1905 ELMORE ST
Second Line	:	APT 409
City	:	CINCINNATI
State	:	OH
Zip	:	45223-2394
Country	:	US
Telephone Number	:	513-364-4110
Fax Number	:

Provider Business Practice Location Address
First Line	:	1905 ELMORE ST
Second Line	:	APT 409
City	:	CINCINNATI
State	:	OH
Zip	:	45223-2394
Country	:	US
Telephone Number	:	513-364-4110
Fax Number	:

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

Provider Enumeration Date	:	04/26/2013
Last Update Date	:	04/26/2013

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