Provider Demographics
NPI:1770355182
Name:KREIDLER, STEFANIE ANN (PMHNP)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:ANN
Last Name:KREIDLER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:608 OAK COVE CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-2190
Mailing Address - Country:US
Mailing Address - Phone:248-535-8231
Mailing Address - Fax:
Practice Address - Street 1:2055 N MOUNT JULIET RD STE 204
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-4296
Practice Address - Country:US
Practice Address - Phone:615-488-3592
Practice Address - Fax:615-845-1777
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN35021363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health