| Doctor Name: | MISS STEPHANIE IRENE HISSIM |
| NPI Number: | 1053742122 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP013436 |
| Business Practice Address: | 200 E Brown St East Stroudsburg, PA - 183013006 |
| Business Phone Number: | 5704763700 |
| Business Fax Number: | 5704763637 |
| Mailing Address: | 206 E Brown St, EAST STROUDSBURG |
| State: | PA |
| Postal Code: | 183013006 |
| Phone Number: | 5704763700 |
| Fax Number: | 5704763637 |
| NPI Enumeration Date: | 11/27/2013 |
| NPI Last Update Date: | 09/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | SP013436 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |