Provider Demographics
NPI:1518473602
Name:WINGERTER, STEPHANIE JO (CRNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JO
Last Name:WINGERTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:JO
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:640 KOLTER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3570
Mailing Address - Country:US
Mailing Address - Phone:724-357-7234
Mailing Address - Fax:
Practice Address - Street 1:841 HOSPITAL RD STE 3100
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3635
Practice Address - Country:US
Practice Address - Phone:724-349-7820
Practice Address - Fax:724-349-8816
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018145363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care