Provider Demographics
NPI:1952705881
Name:REXILIUS, STEPHANIE JEAN (ANP-C)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JEAN
Last Name:REXILIUS
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1150 STATE HIGHWAY 248
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-3758
Mailing Address - Country:US
Mailing Address - Phone:417-348-8964
Mailing Address - Fax:417-336-0275
Practice Address - Street 1:1150 STATE HIGHWAY 248
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-3758
Practice Address - Country:US
Practice Address - Phone:417-348-8964
Practice Address - Fax:417-336-0275
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014021884363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health