Provider Demographics
NPI:1881116796
Name:BACKER, STEPHANIE LOLA (APRN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LOLA
Last Name:BACKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8500 NW 38TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-2906
Mailing Address - Country:US
Mailing Address - Phone:954-736-9895
Mailing Address - Fax:
Practice Address - Street 1:10151 ENTERPRISE CTR STE 106
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3760
Practice Address - Country:US
Practice Address - Phone:561-734-7400
Practice Address - Fax:561-734-7448
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT8820363LF0000X
COC-APN.0003438-C-NP363LF0000X
FL9334103363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily