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Individual
STEPHANIE RENEE LEVY
Active
Individual
STEPHANIE RENEE LEVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA060002
PA
363AM0700X
Medical Physician Assistant
21460
CA
363AS0400X
Surgical Physician Assistant
001853
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110-005433
STATE LICENSE
VA
01
—
21460
STATE LICENSE
CA
Enumeration date
01/19/2007
Last updated
09/30/2024
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