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General NPI Number Information
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NPI Number | 1528700184
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Entity Type | Individual
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Provider Name | STEPHANIE HERRON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 4000 S TULIP TREE DR
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City | PRINCETON
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State | IN
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Zip | 47670-2300
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Country | US
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Telephone | 812-387-2922
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 N BOEHNE CAMP RD
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City | EVANSVILLE
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State | IN
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Zip | 47720-3372
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Country | US
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Telephone | 812-205-5601
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71012483A
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License Number State | IN
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