| Doctor Name: | MS. STEPHANI L POE |
| NPI Number: | 1336495985 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PTA |
| License Number: | 000921426 |
| Business Practice Address: | 3122 Brettwood Cir Decatur, IL - 625262425 |
| Business Phone Number: | 2178764600 |
| Business Fax Number: | 2178764625 |
| Mailing Address: | 817 E Illinois St, ARTHUR |
| State: | IL |
| Postal Code: | 619111631 |
| Phone Number: | 2178764600 |
| Fax Number: | 2178764625 |
| NPI Enumeration Date: | 08/01/2012 |
| NPI Last Update Date: | 08/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146M00000X |
| License Number: | 000921426 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Intermediate |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An Intermediate EMT is an individual trained and certified to perform intermediate life support treatment in medical emergencies based on individual state boards. |