Provider Demographics
NPI:1801413448
Name:OPARAUGO, STEPHINE (DNP)
Entity Type:Individual
Prefix:
First Name:STEPHINE
Middle Name:
Last Name:OPARAUGO
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 BATTERY LN APT 3
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4902
Mailing Address - Country:US
Mailing Address - Phone:202-437-0166
Mailing Address - Fax:
Practice Address - Street 1:4901 BATTERY LN APT 3
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4902
Practice Address - Country:US
Practice Address - Phone:202-437-0166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402994363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health