Provider Demographics
NPI:1609393784
Name:STEPANOFF, FRANCINE CHRISTINE
Entity Type:Individual
Prefix:
First Name:FRANCINE
Middle Name:CHRISTINE
Last Name:STEPANOFF
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:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:CHIGNIK LAKE
Mailing Address - State:AK
Mailing Address - Zip Code:99548
Mailing Address - Country:US
Mailing Address - Phone:907-845-2236
Mailing Address - Fax:
Practice Address - Street 1:33 CLINIC ROAD
Practice Address - Street 2:
Practice Address - City:CHIGNIK LAKE
Practice Address - State:AK
Practice Address - Zip Code:99548
Practice Address - Country:US
Practice Address - Phone:907-845-2236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK13-1240III172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker