Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 28140568A | IN |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 71006397A | IN |
NPI | 1053771535 |
---|---|
Provider Name | Stephanie Sciaudone |
First Address | Noblesville, IN 46060-4360 |
Second Address | Anderson, IN 46016-4204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2016 |
Last Update Date | 19/07/2016 |