Provider Demographics
NPI:1568080570
Name:RAMIREZ, STEPHANIE MEGAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MEGAN
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3624 W ANTHEM WAY STE C108
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-0457
Mailing Address - Country:US
Mailing Address - Phone:623-688-5490
Mailing Address - Fax:
Practice Address - Street 1:3624 W ANTHEM WAY STE C108
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-0457
Practice Address - Country:US
Practice Address - Phone:623-688-5490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ238080363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner