Provider Demographics
NPI:1043837453
Name:PEBLER, STEFANIA (RN)
Entity Type:Individual
Prefix:
First Name:STEFANIA
Middle Name:
Last Name:PEBLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 598
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:NY
Mailing Address - Zip Code:12413-0598
Mailing Address - Country:US
Mailing Address - Phone:518-622-0490
Mailing Address - Fax:518-622-0493
Practice Address - Street 1:1301 ROUTE 145
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:NY
Practice Address - Zip Code:12413-2148
Practice Address - Country:US
Practice Address - Phone:518-622-0490
Practice Address - Fax:518-622-0493
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY734911163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool