Provider Demographics
NPI:1841922754
Name:ABERNATHY-LANE, STEPHANIE M
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:M
Last Name:ABERNATHY-LANE
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 1:26430 PENN ST
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-2643
Mailing Address - Country:US
Mailing Address - Phone:313-610-6327
Mailing Address - Fax:
Practice Address - Street 1:26430 PENN ST
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-2643
Practice Address - Country:US
Practice Address - Phone:313-610-6327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care