Provider Demographics
NPI:1659368744
Name:FLASPOEHLER, STEPHANIE A (ARNP)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:A
Last Name:FLASPOEHLER
Suffix:
Gender:F
Credentials:ARNP
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 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:4123 DUTCHMANS LN STE 307
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4721
Practice Address - Country:US
Practice Address - Phone:502-409-5600
Practice Address - Fax:502-259-3078
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001757A363L00000X
KY4317P363L00000X
KY3004317363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78012358Medicaid
INP00178215OtherRR MCR
IN200484660Medicaid
KY78012358Medicaid
Q18740Medicare UPIN
IN200484660Medicaid