Provider Demographics
NPI:1376369421
Name:LOZANO, STEPHANIE ANN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:LOZANO
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 1:863 CAREW RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7019
Mailing Address - Country:US
Mailing Address - Phone:757-613-3398
Mailing Address - Fax:
Practice Address - Street 1:3143 MAGIC HOLLOW BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-3077
Practice Address - Country:US
Practice Address - Phone:757-385-8222
Practice Address - Fax:757-368-3438
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024190405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health