Individual
STEPHANIE L TRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3978 NEW VISION DR, FORT WAYNE, IN 46845-1712
(260) 672-4680
(260) 458-5836
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71004654A
IN
363LF0000X
Family Nurse Practitioner
28162213A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71004654A
IN
363LP2300X
Primary Care Nurse Practitioner
71004654A
IN
Other
Enumeration date
08/01/2013
Last updated
09/03/2024
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