Healthcare Provider Details

I. General information

NPI: 1679195770
Provider Name (Legal Business Name): STEPHANIE FRANK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 PRAY BLVD
WATERVILLE OH
43566-8717
US

IV. Provider business mailing address

1222 PRAY BLVD
WATERVILLE OH
43566-8717
US

V. Phone/Fax

Practice location:
  • Phone: 419-441-4252
  • Fax: 419-441-4255
Mailing address:
  • Phone: 419-441-4252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0026907
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: