Provider Demographics
NPI:1720376445
Name:GREEN, STEPHANIE B (ACNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:B
Last Name:GREEN
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:B
Other - Last Name:KRAMPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP
Mailing Address - Street 1:801 SAINT MARYS DR STE 205W
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0556
Mailing Address - Country:US
Mailing Address - Phone:812-477-6103
Mailing Address - Fax:
Practice Address - Street 1:4199 GATEWAY BLVD
Practice Address - Street 2:SUITE 2600
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8970
Practice Address - Country:US
Practice Address - Phone:812-842-4530
Practice Address - Fax:812-842-4535
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003886A363LA2100X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care