Provider Demographics
NPI:1619331980
Name:HOUGH, STEPHEN (FNP)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:HOUGH
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4870 WUNNENBERG WAY
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-4863
Mailing Address - Country:US
Mailing Address - Phone:513-860-4600
Mailing Address - Fax:513-860-9059
Practice Address - Street 1:360 WILSON DR
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-1870
Practice Address - Country:US
Practice Address - Phone:937-281-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA19028363LF0000X
OHAPRN.CNP.19028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOA19028OtherLICENSE NUMBER