Healthcare Provider Details

I. General information

NPI: 1558768549
Provider Name (Legal Business Name): STEPHANIE LYNNE STRAGAND CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2014
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 RIVER RD
BEAVER PA
15009-2735
US

IV. Provider business mailing address

628 RIVER RD
BEAVER PA
15009-2735
US

V. Phone/Fax

Practice location:
  • Phone: 724-312-5266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN594976
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP014458
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: