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General NPI Number Information
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NPI Number | 1871034587
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Entity Type | Individual
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Provider Name | MS. STEPHANIE JOSEPH
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Gender | Female
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 07/28/2017
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Provider Practice Location Address
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Address Line | 4316 SUBLIME TRL
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City | ATLANTA
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State | GA
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Zip | 30349-8882
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Country | US
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Telephone | 978-424-1037
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Fax |
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Provider Business Mailing Address
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Address Line | 707 YORK RD APT 3209
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City | TOWSON
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State | MD
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Zip | 21204-2877
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Country | US
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Telephone | 978-424-1037
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | R227375
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License Number State | MD
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