Healthcare Provider Details

I. General information

NPI: 1447752910
Provider Name (Legal Business Name): STEPHANIE NICOLE CIOCI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 TAUB LOOP
HOUSTON TX
77030
US

IV. Provider business mailing address

24803 MEADOW OAKS DRIVE
KATY TX
77494
US

V. Phone/Fax

Practice location:
  • Phone: 713-798-8650
  • Fax:
Mailing address:
  • Phone: 832-858-4429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP136348
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number821467
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number116904
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: