Provider Demographics
NPI:1245630532
Name:MCDONALD, STEPHANIE J (FNP-BC, APRN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:J
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:FNP-BC, APRN
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:J
Other - Last Name:D'AMICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, FNP-BC,APRN
Mailing Address - Street 1:LAHEY HOSPITAL & MEDICAL CENTER
Mailing Address - Street 2:41 MALL ROAD
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8400
Mailing Address - Fax:781-744-5245
Practice Address - Street 1:41 MALL RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-1000
Practice Address - Country:US
Practice Address - Phone:781-744-8400
Practice Address - Fax:781-744-5245
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH069333-23363LF0000X
MAMD3280928363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily