Healthcare Provider Details

I. General information

NPI: 1558447466
Provider Name (Legal Business Name): STEPHANIE ALTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE ZAPPA

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 EASTLAND AVE SE SUITE 301
WARREN OH
44484-4503
US

IV. Provider business mailing address

7067 TIFFANY BLVD STE 230
YOUNGSTOWN OH
44514-1981
US

V. Phone/Fax

Practice location:
  • Phone: 330-841-4046
  • Fax:
Mailing address:
  • Phone: 330-758-2748
  • Fax: 330-758-3282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN.142133-COA1
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: