Provider Demographics
NPI:1225646094
Name:FIORE, STEPHANIE (MS, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:FIORE
Suffix:
Gender:F
Credentials:MS, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 WEST STREET
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489
Mailing Address - Country:US
Mailing Address - Phone:860-276-6099
Mailing Address - Fax:860-276-6062
Practice Address - Street 1:1115 WEST ST
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-6025
Practice Address - Country:US
Practice Address - Phone:860-276-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-17
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT112172163W00000X
CT8942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse