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NPI Code Detail

MEDICARE: STEPHANIE HARE RN

MEDICARE: STEPHANIE HARE RN
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 Practitioner5384908122KS

General Provider Information

NPI Number : 1770332983
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE HARE RN
Provider Business Mailing Address
First Line : 300 TICE BLVD STE 175
Second Line :
City : WOODCLIFF LAKE
State : NJ
Zip : 07677-8405
Country : US
Telephone Number : 201-851-4665
Fax Number :
Provider Business Practice Location Address
First Line : 14800 W SAINT TERESA ST
Second Line :
City : WICHITA
State : KS
Zip : 67235-9602
Country : US
Telephone Number : 316-796-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2024
Last Update Date : 12/11/2025

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