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General NPI Number Information
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NPI Number | 1427968692
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Entity Type | Individual
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Provider Name | STEPHANIE MEYSEMBOURG PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 2355 POPLAR LEVEL RD STE G1
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City | LOUISVILLE
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State | KY
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Zip | 40217-1367
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Country | US
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Telephone | 502-636-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 610 COVENTRY WAY
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City | NOBLESVILLE
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State | IN
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Zip | 46062-9027
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Country | US
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Telephone | 317-941-9525
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State | KY
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