Healthcare Provider Details

I. General information

NPI: 1639605819
Provider Name (Legal Business Name): DAVID STEMEN CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 ALLENTOWN RD
LIMA OH
45805-1705
US

IV. Provider business mailing address

PO BOX 639982
CINCINNATI OH
45263-9882
US

V. Phone/Fax

Practice location:
  • Phone: 419-227-2245
  • Fax: 419-229-1573
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.021792
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberAPRN.CNP.021792
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberAPRN.CNP.021792
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: