| Doctor Name: | MS. STEPHANIE ANN KASBERG |
| NPI Number: | 1114300852 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C, APRN, RN |
| License Number: | 6146 |
| Business Practice Address: | 22 Laurel St Niantic, CT - 063572622 |
| Business Phone Number: | 6145866534 |
| Business Fax Number: | |
| Mailing Address: | 20 York St, NEW HAVEN |
| State: | CT |
| Postal Code: | 065103220 |
| Phone Number: | 2032004363 |
| Fax Number: | |
| NPI Enumeration Date: | 06/30/2015 |
| NPI Last Update Date: | 11/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 6146 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |