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NPI Code Detail

MEDICARE: MS. STEPHANIE DIANE TEN EYCK NP-C

MEDICARE:  MS. STEPHANIE DIANE TEN EYCK  NP-C
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
1363LF0000XFamily Nurse PractitionerGAA-NP000127GA
2363LF0000XFamily Nurse Practitioner2024035289MO
3363LF0000XFamily Nurse PractitionerAP61601534WA
4363LF0000XFamily Nurse PractitionerAPRN-4120HI
5363LF0000XFamily Nurse Practitioner4027630KY
6363LF0000XFamily Nurse Practitioner10002819OR
7363LF0000XFamily Nurse PractitionerSP032494PA
8363LF0000XFamily Nurse Practitioner0032075OH
9363LF0000XFamily Nurse Practitioner5021249NC
10363LF0000XFamily Nurse Practitioner33250TN
11363LF0000XFamily Nurse Practitioner1046809TX
12363LF0000XFamily Nurse Practitioner30145SC
13363LF0000XFamily Nurse PractitionerAPRN11003523FL
14363LF0000XFamily Nurse PractitionerAP7670AZ
15363LF0000XFamily Nurse PractitionerC-APN.004478-C-NPCO

General Provider Information

NPI Number : 1487043923
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEPHANIE DIANE TEN EYCK NP-C
Provider Business Mailing Address
First Line : PO BOX 211699
Second Line :
City : EAGAN
State : MN
Zip : 55121-3699
Country : US
Telephone Number : 866-849-0692
Fax Number : 888-973-8821
Provider Business Practice Location Address
First Line : 1055 HOWELL MILL RD NW
Second Line :
City : ATLANTA
State : GA
Zip : 30318-5557
Country : US
Telephone Number : 866-849-0692
Fax Number : 888-973-8821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2015
Last Update Date : 09/22/2025

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