Individual
STEPHANIE STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2745 HARNEY PATH STE 187, JBSA FT SAM HOUSTON, TX 78234-7678
(210) 221-3201
Mailing address
2814 WHEATON RD, JBSA FSH, TX 78234-2673
(715) 781-5742
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1967566
MN
163W00000X
Registered Nurse
262268-30
WI
364S00000X
Clinical Nurse Specialist
14937-33
WI
364S00000X
Clinical Nurse Specialist
Primary
652
MN
Other
Enumeration date
12/21/2023
Last updated
10/21/2024
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