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General NPI Number Information
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NPI Number | 1578764072
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Entity Type | Individual
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Provider Name | STEPHANIE LOIS HUME CNM
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9333 SW 152ND ST
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City | VILLAGE OF PALMETTO BAY
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State | FL
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Zip | 33157-1778
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Country | US
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Telephone | 305-256-5356
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Fax |
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Provider Business Mailing Address
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Address Line | 11045 SW 168TH ST
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City | MIAMI
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State | FL
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Zip | 33157-4008
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Country | US
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Telephone | 305-255-8191
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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 | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 1069782
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License Number State | FL
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