Provider Demographics
NPI:1649892647
Name:SMITH, STEPHANIE ZHU (APRN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ZHU
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4431
Mailing Address - Country:US
Mailing Address - Phone:203-548-1549
Mailing Address - Fax:
Practice Address - Street 1:112 QUARRY RD STE 400
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4877
Practice Address - Country:US
Practice Address - Phone:203-333-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2019078117363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily