Provider Demographics
NPI:1205209731
Name:KAGAN, STEPHANIE ELIZABETH-EATON (NP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ELIZABETH-EATON
Last Name:KAGAN
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Mailing Address - Street 1:1245 HIGHLAND AVE
Mailing Address - Street 2:STE 404
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3714
Mailing Address - Country:US
Mailing Address - Phone:215-887-2010
Mailing Address - Fax:
Practice Address - Street 1:1245 HIGHLAND AVE
Practice Address - Street 2:STE 404
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3714
Practice Address - Country:US
Practice Address - Phone:215-887-2010
Practice Address - Fax:215-887-3291
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAKAG104395771363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health