Healthcare Provider Details

I. General information

NPI: 1801898820
Provider Name (Legal Business Name): STEPHANIE HOSMAN RNCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THORNDIKE ST
BEVERLY MA
01915-5858
US

IV. Provider business mailing address

143 STATE ST
NEWBURYPORT MA
01950-6621
US

V. Phone/Fax

Practice location:
  • Phone: 978-790-3354
  • Fax: 978-927-5338
Mailing address:
  • Phone: 978-462-2890
  • Fax: 978-462-2890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number164463
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberMH0215031L
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: