Provider Demographics
NPI:1639811193
Name:KOCHERSPERGER, STEPHANIE (PMHNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:KOCHERSPERGER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 KENDERTON AVE
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-2432
Mailing Address - Country:US
Mailing Address - Phone:215-817-7946
Mailing Address - Fax:
Practice Address - Street 1:156 S BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5821
Practice Address - Country:US
Practice Address - Phone:215-767-7096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025535363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health