Healthcare Provider Details

I. General information

NPI: 1427911346
Provider Name (Legal Business Name): STEPHANIE PARKER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W 4TH ST
MOUNT VERNON NY
10550-4002
US

IV. Provider business mailing address

575 BRONX RIVER RD APT 2H
YONKERS NY
10704-1705
US

V. Phone/Fax

Practice location:
  • Phone: 914-699-7200
  • Fax:
Mailing address:
  • Phone: 718-300-9427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number002406
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: