Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3016014 | KY |
N | 363LP2300X | Nurse Practitioner - Primary Care | 3016014 | KY |
NPI | 1053980995 |
---|---|
Provider Name | Sarah Catherine Stephenson |
First Address | Florence, KY 41042-9353 |
Second Address | Edgewood, KY 41017-3403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2021 |
Last Update Date | 04/11/2021 |