| Doctor Name: | STEPHANIE LORRAINE JERNIGAN |
| NPI Number: | 1093110314 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | AL8945H |
| Business Practice Address: | 12838 W Valentine Ave El Mirage, AZ - 853358206 |
| Business Phone Number: | 6232663546 |
| Business Fax Number: | |
| Mailing Address: | 12838 W Valentine Ave, EL MIRAGE |
| State: | AZ |
| Postal Code: | 853358206 |
| Phone Number: | 6232663546 |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2014 |
| NPI Last Update Date: | 10/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 376G00000X |
| License Number: | AL8945H |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Nursing Service Related Providers |
| Taxonomy Classification: | Nursing Home Administrator |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual, often licensed by the state, who is responsible for the management of a nursing home. |