Provider Demographics
NPI:1427356823
Name:FARMER, STEPHANIE L (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:FARMER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BOW ST
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5544
Mailing Address - Country:US
Mailing Address - Phone:410-398-4000
Mailing Address - Fax:
Practice Address - Street 1:665 CHURCHMANS RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1918
Practice Address - Country:US
Practice Address - Phone:302-731-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9273508363L00000X
PASP014325363LA2200X
MDR121652363LA2200X
DELP0000292363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003331900Medicaid
FLET497YMedicare UPIN