| Doctor Name: | MS. STEPHANIE LOUISE HERRICK |
| NPI Number: | 1083702716 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | AP328 |
| Business Practice Address: | 1987 Mcculloch Blvd N Ste 101 Lake Havasu City, AZ - 864035682 |
| Business Phone Number: | 9284536963 |
| Business Fax Number: | 9284537011 |
| Mailing Address: | 1988 Spruce Dr, LAKE HAVASU CITY |
| State: | AZ |
| Postal Code: | 864067514 |
| Phone Number: | 9285756713 |
| Fax Number: | |
| NPI Enumeration Date: | 10/10/2006 |
| NPI Last Update Date: | 09/10/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP328 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |