Healthcare Provider Details

I. General information

NPI: 1336583996
Provider Name (Legal Business Name): STEFANNI ESTONILO KEY MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 03/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 NORMAN DR STE 3
LEBANON PA
17042-7559
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-270-7908
  • Fax: 717-272-1734
Mailing address:
  • Phone: 717-851-1405
  • Fax: 717-851-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP013203
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: