Healthcare Provider Details

I. General information

NPI: 1063322295
Provider Name (Legal Business Name): STEPHANIE HESSLER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S 4TH ST
FULTON NY
13069-1804
US

IV. Provider business mailing address

103 S 4TH ST
FULTON NY
13069-1804
US

V. Phone/Fax

Practice location:
  • Phone: 315-992-2492
  • Fax:
Mailing address:
  • Phone: 315-992-2492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number324477
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: