Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 4704282695 | MI |
NPI | 1013683366 |
---|---|
Provider Name | Mrs. Denise Patricia Stepanovich |
First Address | Lowell, MI 49331-8982 |
Second Address | Ionia, MI 48846-8671 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2021 |
Last Update Date | 17/08/2021 |