Provider Demographics
NPI:1104697689
Name:AHN, STEFFANY ADRIANA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:STEFFANY
Middle Name:ADRIANA
Last Name:AHN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20855 S LAGRANGE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-2043
Mailing Address - Country:US
Mailing Address - Phone:773-985-3539
Mailing Address - Fax:
Practice Address - Street 1:13740 N HIGHWAY 183 STE L2
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1833
Practice Address - Country:US
Practice Address - Phone:773-985-3539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031259363LP0808X
TX1169433363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health