Healthcare Provider Details

I. General information

NPI: 1205270774
Provider Name (Legal Business Name): STEPHANIE MICHELE MILTON STNA/MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2013
Last Update Date: 04/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 ELMORE ST APT 409
CINCINNATI OH
45223-2394
US

IV. Provider business mailing address

1905 ELMORE ST APT 409
CINCINNATI OH
45223-2394
US

V. Phone/Fax

Practice location:
  • Phone: 513-364-4110
  • Fax:
Mailing address:
  • Phone: 513-364-4110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number400715680208
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: