Individual
STEPHANIE DAWN ICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
227 MEDICAL PARK DR STE 103, BRIDGEPORT, WV 26330-9038
(681) 342-3500
Mailing address
PO BOX 952, BARRACKVILLE, WV 26559-0952
(304) 816-6000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN75904-FNP-BC
WV
Other
Enumeration date
08/08/2017
Last updated
04/05/2022
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