Provider Demographics
NPI:1295371094
Name:VOWELL, STEPHANIE M (CRNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:VOWELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6323 DON ZAREMBO AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-3350
Mailing Address - Country:US
Mailing Address - Phone:609-647-4307
Mailing Address - Fax:
Practice Address - Street 1:6323 DON ZAREMBO AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-3350
Practice Address - Country:US
Practice Address - Phone:702-610-9740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-27
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV819893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily