Healthcare Provider Details

I. General information

NPI: 1316517337
Provider Name (Legal Business Name): STEPHANIE ERIN TEWES CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 WESTON RD
WESTON FL
33331-3602
US

IV. Provider business mailing address

1100 3RD AVE N APT 475
NASHVILLE TN
37208-3185
US

V. Phone/Fax

Practice location:
  • Phone: 954-987-2000
  • Fax:
Mailing address:
  • Phone: 954-736-9880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number9408998
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number33187
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: