Provider Demographics
NPI:1811505639
Name:YORTY, STEPHANIE E (CRNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:E
Last Name:YORTY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 EAST AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BERNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19506-9044
Mailing Address - Country:US
Mailing Address - Phone:610-488-7080
Mailing Address - Fax:610-488-9796
Practice Address - Street 1:44 EAST AVE
Practice Address - Street 2:
Practice Address - City:BERNVILLE
Practice Address - State:PA
Practice Address - Zip Code:19506-9044
Practice Address - Country:US
Practice Address - Phone:610-488-7080
Practice Address - Fax:610-488-9796
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022199363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily