Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 25ME00044401 | NJ |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | ARNP9289046 | FL |
NPI | 1003016932 |
---|---|
Provider Name | Ms. Linda Jean Stephan |
First Address | Saint Petersburg, FL 33710 |
Second Address | Saint Petersburg, FL 33710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2007 |
Last Update Date | 02/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25ME00044401 | CNM LICENSE (01) | NJ |
ARNP9289046 | BOARD OF NURSING LICENSE (01) | FL |