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NPI Code Detail

MEDICARE: MRS. STEPHANIE CRESS

MEDICARE: MRS. STEPHANIE CRESS
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
1363A00000XPhysician Assistant085003542IL
2363A00000XPhysician Assistant0100009-1NY
3363AM0700XMedical Physician Assistant085003542IL
4363A00000XPhysician AssistantPA9113613FL

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 : 1285655647
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEPHANIE CRESS
Provider Business Mailing Address
First Line : 2309 E 15TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-6345
Country : US
Telephone Number : 850-747-5272
Fax Number :
Provider Business Practice Location Address
First Line : 2309 E 15TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-6345
Country : US
Telephone Number : 850-747-5272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 04/12/2023

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Directions to “ MRS. STEPHANIE CRESS ” Practice Location

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