Provider Demographics
NPI:1730669953
Name:KINTZING, STEPHANIE ELLEN (APN, WHNP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ELLEN
Last Name:KINTZING
Suffix:
Gender:F
Credentials:APN, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HAWTHORNE AVE APT E
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-3207
Mailing Address - Country:US
Mailing Address - Phone:201-994-9341
Mailing Address - Fax:
Practice Address - Street 1:841 FRANKLIN AVE STE 5
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1418
Practice Address - Country:US
Practice Address - Phone:201-891-8811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00849100363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health