Provider Demographics
NPI:1326435991
Name:WEINGARD, STEPHANIE LOUISE (MSN, APRN, PMHNP-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LOUISE
Last Name:WEINGARD
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-C
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:KAELIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:7901 4TH ST N STE 300
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4399
Mailing Address - Country:US
Mailing Address - Phone:843-474-5578
Mailing Address - Fax:843-790-1871
Practice Address - Street 1:7901 4TH ST N STE 300
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4399
Practice Address - Country:US
Practice Address - Phone:843-474-5578
Practice Address - Fax:843-790-1871
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF404134-01363LP0808X
AZ271605363LP0808X
MARN2360527363LP0808X
FLAPRN11000411363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
2018035145OtherANCC BOARD CERTIFICATION NUMBER
FL11000411OtherDEPARTMENT OF HEALTH LICENSE - APRN