Provider Demographics
NPI:1184006462
Name:DENMARK, STEPHANIE RENEE (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:RENEE
Last Name:DENMARK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5690 OGEECHEE RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-9500
Mailing Address - Country:US
Mailing Address - Phone:912-234-5575
Mailing Address - Fax:
Practice Address - Street 1:5690 OGEECHEE RD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-9500
Practice Address - Country:US
Practice Address - Phone:912-234-5575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN160261363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner