Provider Demographics
NPI:1457831075
Name:STETINA, STEPHANIE H
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:H
Last Name:STETINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 W 15 STREET, STE. 1025
Mailing Address - Street 2:PITMAN ATRIUM TOWER
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075
Mailing Address - Country:US
Mailing Address - Phone:972-673-0404
Mailing Address - Fax:
Practice Address - Street 1:4524 BROOKRIDGE DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3810
Practice Address - Country:US
Practice Address - Phone:972-234-8183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX621633163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse