Provider Demographics
NPI:1720205818
Name:ARDEN, STEPHANIE KAYE (BSN, RN, CRRN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KAYE
Last Name:ARDEN
Suffix:
Gender:F
Credentials:BSN, RN, CRRN
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 206
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43469-0206
Mailing Address - Country:US
Mailing Address - Phone:419-849-2204
Mailing Address - Fax:419-849-2209
Practice Address - Street 1:717 FORT FINDLAY RD
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:OH
Practice Address - Zip Code:43469-1407
Practice Address - Country:US
Practice Address - Phone:419-849-2204
Practice Address - Fax:419-849-2209
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN259569171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator