Provider Demographics
NPI:1609529460
Name:YAZDANYAR, STEPHANIE (CRNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:YAZDANYAR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 S. CEDAR CREST BLVD
Mailing Address - Street 2:3RD FLOOR, ANDERSON WING
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103
Mailing Address - Country:US
Mailing Address - Phone:610-402-5369
Mailing Address - Fax:
Practice Address - Street 1:1200 S. CEDAR CREST BLVD
Practice Address - Street 2:3RD FLOOR, ANDERSON WING
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103
Practice Address - Country:US
Practice Address - Phone:610-402-5369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019085363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care