Healthcare Provider Details

I. General information

NPI: 1235062589
Provider Name (Legal Business Name): STEPHANIE MARIE CROSS FNP-C, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 N GRAND ST
SCHOOLCRAFT MI
49087-5110
US

IV. Provider business mailing address

PO BOX 300
MENDON MI
49072-0300
US

V. Phone/Fax

Practice location:
  • Phone: 269-762-0223
  • Fax:
Mailing address:
  • Phone: 269-625-2564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704281275
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: