Provider Demographics
NPI:1346738432
Name:YORK, STEPHANIE RENEE (NP-C)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:RENEE
Last Name:YORK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 AVON BELDEN RD
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:OH
Mailing Address - Zip Code:44044-9805
Mailing Address - Country:US
Mailing Address - Phone:440-748-1049
Mailing Address - Fax:
Practice Address - Street 1:2075 AVON BELDEN RD
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:OH
Practice Address - Zip Code:44044-9805
Practice Address - Country:US
Practice Address - Phone:440-748-1049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH021935363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHF10170308OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD
OH021935OtherOHIO BOARD OF NURSING-NP
OH405315OtherOHIO BOARD OF NURSING