Individual
MS. STEPHANIE TARA STANCEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
3815 HARRISON RD, LOGANVILLE, GA 30052-2462
(770) 466-6112
Mailing address
1525 LAUREL CROSSING PKWY, APARTMENT 202, BUFORD, GA 30519-6562
(770) 364-4061
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN169676
GA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN169676
GA
Other
Enumeration date
06/30/2010
Last updated
03/04/2014
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