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General NPI Number Information
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NPI Number | 1487043923
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Entity Type | Individual
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Provider Name | STEPHANIE DIANE TEN EYCK NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1055 HOWELL MILL RD NW
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City | ATLANTA
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State | GA
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Zip | 30318-5557
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Country | US
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Telephone | 866-849-0692
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Fax | 888-973-8821
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Provider Business Mailing Address
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Address Line | PO BOX 211699
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City | EAGAN
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State | MN
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Zip | 55121-3699
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Country | US
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Telephone | 866-849-0692
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Fax | 888-973-8821
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | GAA-NP000127
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2024035289
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61601534
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-4120
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License Number State | HI
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4027630
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10002819
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License Number State | OR
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP032494
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License Number State | PA
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0032075
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License Number State | OH
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Taxonomy #9
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5021249
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License Number State | NC
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Taxonomy #10
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 33250
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License Number State | TN
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Taxonomy #11
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1046809
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License Number State | TX
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Taxonomy #12
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 30145
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License Number State | SC
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Taxonomy #13
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11003523
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License Number State | FL
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Taxonomy #14
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP7670
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License Number State | AZ
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Taxonomy #15
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.004478-C-NP
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License Number State | CO
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