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General NPI Number Information
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NPI Number | 1912547332
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Entity Type | Individual
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Provider Name | STEPHANIE MARIE KING APRN
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Gender | Female
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-2417
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Country | US
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Telephone | 216-986-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 20230 GLEN RUSS LN
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City | EUCLID
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State | OH
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Zip | 44117-2417
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Country | US
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Telephone | 162-374-3037
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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 | APRN.CNP.0036130
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License Number State | OH
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