Provider Demographics
NPI:1770257271
Name:ARDOVINO, STEPHANIE ANN (MSN, CRNP, AGNP-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:ARDOVINO
Suffix:
Gender:F
Credentials:MSN, CRNP, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 ARNOLD RD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5822
Mailing Address - Country:US
Mailing Address - Phone:205-876-4272
Mailing Address - Fax:
Practice Address - Street 1:4600 US-280
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242
Practice Address - Country:US
Practice Address - Phone:205-408-1231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-176010163W00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse