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General NPI Number Information
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NPI Number | 1265745525
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN POGUE RD, RN, NP, BC-PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 546 ROBINDALE DR
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City | WEBSTER
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State | NY
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Zip | 14580-4082
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Country | US
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Telephone | 585-261-0433
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Fax |
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Provider Business Mailing Address
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Address Line | 546 ROBINDALE DR
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City | WEBSTER
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State | NY
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Zip | 14580-4082
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Country | US
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Telephone | 585-261-0433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT90983
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 011361
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 408676
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License Number State | NY
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