Individual
STEFANIE L DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7777 HENNESSY BLVD, BATON ROUGE, LA 70808-4300
(225) 765-7163
Mailing address
DEPT AT952639, ATLANTA, GA 31192-2639
(800) 684-0857
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07007
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2315358
—
LA
Enumeration date
07/30/2012
Last updated
01/03/2013
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