Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN9191475 | FL |
NPI | 1003229139 |
---|---|
Provider Name | Mrs. Stephanie Louise Battaglini |
First Address | Rockledge, FL 32955-4306 |
Second Address | Melbourne, FL 32901-3224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2014 |
Last Update Date | 18/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105600900 | (05) | FL |
HW549Z | MEDICARE (01) | FL |