MEDICARE: LUCY M STEPHEN ARNP

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
1	363L00000X	Nurse Practitioner	ARNP2019342	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP2019342	OTHER	FL	ARNP LICENSE

General Provider Information

NPI Number	:	1770536245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCY M STEPHEN ARNP

Provider Business Mailing Address
First Line	:	12973 N TELECOM PKWY
Second Line	:	SUITE 100
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-0907
Country	:	US
Telephone Number	:	813-871-8111
Fax Number	:	813-383-5044

Provider Business Practice Location Address
First Line	:	12973 N TELECOM PKWY
Second Line	:	SUITE 100
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-0907
Country	:	US
Telephone Number	:	813-871-8111
Fax Number	:	813-383-5044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	07/09/2007

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