Organization
SUPREME DIABETES MANAGEMENT AND WEIGHT LOSS TELEHEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA LEANN STEPHERSON CNP (MANAGER)
(740) 851-1325
Entity
Organization
Contact information
Practice address
920 SALINGER DR, LITHOPOLIS, OH 43136-7505
(740) 851-1325
(740) 835-4850
Mailing address
920 SALINGER DR, LITHOPOLIS, OH 43136-7505
(740) 851-1325
(740) 835-4850
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
363L00000X
Nurse Practitioner
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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