Provider Demographics
NPI:1083015762
Name:CORPRON, STEPHANIE (APN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CORPRON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:ARTETA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1515 91ST ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4424
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:46 ESSEX ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4508
Practice Address - Country:US
Practice Address - Phone:201-360-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00521200363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care