Provider Demographics
NPI:1790590107
Name:COE, STEPHANIE LORRAINE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LORRAINE
Last Name:COE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6371 ALMONT DR
Mailing Address - Street 2:
Mailing Address - City:BROOKPARK
Mailing Address - State:OH
Mailing Address - Zip Code:44142-3652
Mailing Address - Country:US
Mailing Address - Phone:216-501-2331
Mailing Address - Fax:
Practice Address - Street 1:6371 ALMONT DR
Practice Address - Street 2:
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-3652
Practice Address - Country:US
Practice Address - Phone:216-501-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRM681839343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)