Provider Demographics
NPI:1962648139
Name:GOLDTHORP, STEPHANIE L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:L
Last Name:GOLDTHORP
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:L
Other - Last Name:IWASKIW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:310 FARM LN
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4732
Mailing Address - Country:US
Mailing Address - Phone:215-348-3990
Mailing Address - Fax:215-348-7705
Practice Address - Street 1:310 FARM LN
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4732
Practice Address - Country:US
Practice Address - Phone:215-348-3990
Practice Address - Fax:215-348-7705
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily