Provider Demographics
NPI:1720689698
Name:COLANGIONE, STEPHANIA ROSE (RN)
Entity Type:Individual
Prefix:
First Name:STEPHANIA
Middle Name:ROSE
Last Name:COLANGIONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 PARKER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-8482
Mailing Address - Country:US
Mailing Address - Phone:931-409-2440
Mailing Address - Fax:
Practice Address - Street 1:482 INTERSTATE DR STE D
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-3409
Practice Address - Country:US
Practice Address - Phone:931-450-8255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33414363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health