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Individual
STEPHANIE ANN BORST
Active
Individual
STEPHANIE ANN BORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063121
NCCPA CERTIFICATE NUMBER
MI
Enumeration date
05/26/2006
Last updated
12/02/2021
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