Healthcare Provider Details

I. General information

NPI: 1528081791
Provider Name (Legal Business Name): NADINE MARKOVICH-STEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W WALNUT ST
SHAMOKIN PA
17872-5226
US

IV. Provider business mailing address

PO BOX 175
NORTHUMBERLAND PA
17857-0175
US

V. Phone/Fax

Practice location:
  • Phone: 570-644-2222
  • Fax: 570-648-4705
Mailing address:
  • Phone: 570-988-0925
  • Fax: 570-988-6445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA0010701
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: