Healthcare Provider Details

I. General information

NPI: 1881427557
Provider Name (Legal Business Name): ANGELA STIEBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 CITY AVE
PENN WYNNE PA
19096-3418
US

IV. Provider business mailing address

93 CANNON PL
ORELAND PA
19075-1101
US

V. Phone/Fax

Practice location:
  • Phone: 610-649-7440
  • Fax:
Mailing address:
  • Phone: 215-470-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: