Provider Demographics
NPI:1841721719
Name:STEPHAN, EMILY R (APRNCNP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:R
Last Name:STEPHAN
Suffix:
Gender:F
Credentials:APRNCNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:OLMSTED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRNCNP
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-8487
Mailing Address - Fax:
Practice Address - Street 1:410 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-8487
Practice Address - Fax:614-293-8153
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRNCNP021131363LA2100X
OHAPRN.CNP.021131363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care