Provider Demographics
NPI:1114237039
Name:NEIMAN, STEPHANIE MICHELLE (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MICHELLE
Last Name:NEIMAN
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7424 GREENVILLE AVE
Mailing Address - Street 2:STE 206
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4552
Mailing Address - Country:US
Mailing Address - Phone:214-363-2004
Mailing Address - Fax:214-378-7483
Practice Address - Street 1:7424 GREENVILLE AVE
Practice Address - Street 2:STE 206
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4552
Practice Address - Country:US
Practice Address - Phone:214-363-2004
Practice Address - Fax:214-378-7483
Is Sole Proprietor?:No
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX745234363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health