Individual
STEPHANIE VERMILLION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, ATC
Contact information
Practice address
1320 N 10TH ST STE B, PHOENIX, AZ 85006-2710
(028) 397-2856
(602) 839-7272
Mailing address
1320 N 10TH ST STE B, PHOENIX, AZ 85006-2710
(602) 839-7285
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363AM0700X
Medical Physician Assistant
Primary
8761
AZ
Other
Enumeration date
04/10/2015
Last updated
12/19/2023
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