Provider Demographics
NPI:1932671963
Name:CARNEIRO, STEPHANIE ELLE (RN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ELLE
Last Name:CARNEIRO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 MCGREGOR ST STE 3200
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3766
Mailing Address - Country:US
Mailing Address - Phone:603-622-8665
Mailing Address - Fax:
Practice Address - Street 1:87 MCGREGOR ST STE 3200
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3766
Practice Address - Country:US
Practice Address - Phone:603-622-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH079484-21163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management