Doctor Name: | MRS. KATIA STEFANOVA |
NPI Number: | 1659621258 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 3007481 |
Business Practice Address: | 1190 W Main St Vevay, IN - 470433639 |
Business Phone Number: | 8124274038 |
Business Fax Number: | 8124273246 |
Mailing Address: | 144 Garritt St, HANOVER |
State: | IN |
Postal Code: | 472439677 |
Phone Number: | 8127012751 |
Fax Number: | |
NPI Enumeration Date: | 09/12/2012 |
NPI Last Update Date: | 09/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3007481 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |