Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | SP024807 | PA |
NPI | 1003574633 |
---|---|
Provider Name | Stephanie Ann Reesman |
First Address | Lower Burrell, PA 15068-3041 |
Second Address | Lower Burrell, PA 15068-3041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2021 |
Last Update Date | 27/01/2022 |