Provider Demographics
NPI:1437266418
Name:FORD, STEPHANIE LYNNE (CPNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNNE
Last Name:FORD
Suffix:
Gender:F
Credentials:CPNP
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6216A NAVAL HOSPITAL BEAUFORT
Mailing Address - Street 2:1 PINCKNEY BLVD ATTN PROFESSIONAL AFFAIRS COORDINATOR
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6148
Mailing Address - Country:US
Mailing Address - Phone:843-228-5577
Mailing Address - Fax:843-228-5196
Practice Address - Street 1:NAVAL HOSPITAL BEAUFORT
Practice Address - Street 2:1 PINCKNEY BLVD ATTN PROFESSIONAL AFFAIRS COORDINATOR
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-6148
Practice Address - Country:US
Practice Address - Phone:843-228-5577
Practice Address - Fax:843-228-5196
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP3366052363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1194784934Medicare UPIN