Provider Demographics
NPI:1417264797
Name:REED, STEFANIE A (WHNP)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:A
Last Name:REED
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4139 BOARDMAN CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9034
Mailing Address - Country:US
Mailing Address - Phone:330-702-1372
Mailing Address - Fax:330-702-1287
Practice Address - Street 1:4139 BOARDMAN CANFIELD RD
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9034
Practice Address - Country:US
Practice Address - Phone:330-702-1372
Practice Address - Fax:330-702-1287
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11805NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11805NPOtherCNP LICENSE