MEDICARE: STEPHANIE JANINE MAGAN MSN, APRN, FNP-BC

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	1019863	TX
2	163WC0200X	Critical Care Medicine Registered Nurse	232931	AR

General Provider Information

NPI Number	:	1679887863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE JANINE MAGAN MSN, APRN, FNP-BC

Provider Business Mailing Address
First Line	:	4301 W MARKHAM ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-7199
Country	:	US
Telephone Number	:	716-598-1621
Fax Number	:

Provider Business Practice Location Address
First Line	:	4301 W MARKHAM ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-7199
Country	:	US
Telephone Number	:	716-598-1621
Fax Number	:

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

Provider Enumeration Date	:	07/30/2010
Last Update Date	:	06/01/2026

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