Provider Demographics
NPI:1013117084
Name:AUSTIN, STEPHANIE (ARNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5802 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-1469
Mailing Address - Country:US
Mailing Address - Phone:813-236-5100
Mailing Address - Fax:
Practice Address - Street 1:5802 N 30TH ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-1469
Practice Address - Country:US
Practice Address - Phone:813-236-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9206024363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology