Healthcare Provider Details

I. General information

NPI: 1013811793
Provider Name (Legal Business Name): STEPHANIE FIDLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 V TWIN DR STE 202
GETTYSBURG PA
17325-7878
US

IV. Provider business mailing address

40 V TWIN DR STE 202
GETTYSBURG PA
17325-7878
US

V. Phone/Fax

Practice location:
  • Phone: 717-339-2710
  • Fax:
Mailing address:
  • Phone: 717-339-2710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN645318
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: