Provider Demographics
NPI:1255847000
Name:GEMBERLING, STEFANIE MARIE
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:MARIE
Last Name:GEMBERLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7214 HUDSON RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-6018
Mailing Address - Country:US
Mailing Address - Phone:330-221-6119
Mailing Address - Fax:
Practice Address - Street 1:15 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-2904
Practice Address - Country:US
Practice Address - Phone:330-996-7730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH145165164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse