Healthcare Provider Details

I. General information

NPI: 1124670484
Provider Name (Legal Business Name): STEPHANIE SCHLESMAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 DEVON PARK DR STE 115
WAYNE PA
19087-1840
US

IV. Provider business mailing address

485 DEVON PARK DR STE 115
WAYNE PA
19087-1840
US

V. Phone/Fax

Practice location:
  • Phone: 484-630-1939
  • Fax: 610-298-9140
Mailing address:
  • Phone: 484-630-1939
  • Fax: 610-298-9140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN623946
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberSP020541
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP031735
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: