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NPI Code Detail

MEDICARE: JUNE ANN STEFANKO FNP

MEDICARE: JUNE ANN STEFANKO FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner4704243451MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073579546
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUNE ANN STEFANKO FNP
Provider Business Mailing Address
First Line : 9249 W LAKE CITY RD
Second Line :
City : HOUGHTON LAKE
State : MI
Zip : 48629-9602
Country : US
Telephone Number : 989-422-5122
Fax Number : 989-422-4378
Provider Business Practice Location Address
First Line : 9249 W LAKE CITY RD
Second Line :
City : HOUGHTON LAKE
State : MI
Zip : 48629-9602
Country : US
Telephone Number : 989-422-5122
Fax Number : 989-422-4378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 12/03/2009

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