Healthcare Provider Details

I. General information

NPI: 1255191961
Provider Name (Legal Business Name): STEPHANIE HERMANN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2152 OLD SPRINGVILLE RD
CENTER POINT AL
35215-4005
US

IV. Provider business mailing address

1251 MONTCLAIRE PL
SCHAUMBURG IL
60173-6553
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: