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Individual
STEPHANIE JEAN MEAD
Active
Individual
STEPHANIE JEAN MEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
612322
NY
363LF0000X
Family Nurse Practitioner
Primary
309596
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05959645
—
NY
Enumeration date
02/13/2020
Last updated
04/04/2022
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