Provider Demographics
NPI:1851985832
Name:GARCIA, STEPHANIE V (CNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:V
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:V
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7911 W 142ND TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2325
Mailing Address - Country:US
Mailing Address - Phone:913-375-8056
Mailing Address - Fax:
Practice Address - Street 1:3308 W EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-6891
Practice Address - Country:US
Practice Address - Phone:573-893-7848
Practice Address - Fax:573-893-1984
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021003531363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily