Provider Demographics
NPI:1376973354
Name:NAJARRO, STEPHANIE INEZ (FNP-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:INEZ
Last Name:NAJARRO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SE BAKER ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-6038
Mailing Address - Country:US
Mailing Address - Phone:503-474-3600
Mailing Address - Fax:503-474-3601
Practice Address - Street 1:320 SE BAKER ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-6038
Practice Address - Country:US
Practice Address - Phone:503-474-3600
Practice Address - Fax:503-474-3601
Is Sole Proprietor?:No
Enumeration Date:2013-11-12
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA813274163WC0400X
CA95013632363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500782156Medicaid
CA95013632OtherNP LICENSE (BOARD OF REGISTERED NURSING)
OR202006669NPOtherNP LICENSE
CA813274OtherRN LICENSE