Provider Demographics
NPI:1548205644
Name:LAMANNA, STEFANIE JUDITH (PHD, ARNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:JUDITH
Last Name:LAMANNA
Suffix:
Gender:F
Credentials:PHD, ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6975 THICKET TRACE
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467
Mailing Address - Country:US
Mailing Address - Phone:561-715-9717
Mailing Address - Fax:561-805-2222
Practice Address - Street 1:840 US HIGHWAY 1
Practice Address - Street 2:SUITE 120
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3830
Practice Address - Country:US
Practice Address - Phone:561-776-8300
Practice Address - Fax:561-776-0727
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2885682363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P56075Medicare UPIN
E72212Medicare ID - Type Unspecified