Provider Demographics
NPI:1043709736
Name:WESTON, STEPHANIE THERESE (DNP FNP)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:THERESE
Last Name:WESTON
Suffix:
Gender:F
Credentials:DNP FNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:THERESE
Other - Last Name:ANSTETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5333 MCAULEY DR RM 4003
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1099
Mailing Address - Country:US
Mailing Address - Phone:734-712-3470
Mailing Address - Fax:
Practice Address - Street 1:5333 MCAULEY DR RM 4003
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1099
Practice Address - Country:US
Practice Address - Phone:734-712-3470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704257171363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily