Provider Demographics
NPI:1508054628
Name:SAVARESE, STEPHANIE L
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:L
Last Name:SAVARESE
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 1:1160 GREAT POND RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1298
Mailing Address - Country:US
Mailing Address - Phone:978-725-6206
Mailing Address - Fax:
Practice Address - Street 1:1160 GREAT POND RD # SON603
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1298
Practice Address - Country:US
Practice Address - Phone:978-725-6206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2277062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily