Healthcare Provider Details

I. General information

NPI: 1235575911
Provider Name (Legal Business Name): STEPHANIE MARIE FILING RN CPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2013
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 LETCHWORTH DR
AKRON OH
44303-1728
US

IV. Provider business mailing address

534 LETCHWORTH DR
AKRON OH
44303-1728
US

V. Phone/Fax

Practice location:
  • Phone: 330-265-5445
  • Fax:
Mailing address:
  • Phone: 330-265-5445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number330994
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number330994
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: