Individual
STEPHANIE A VERDERAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1340 CHARLES ST STE 400, ROCKFORD, IL 61104-2200
(779) 696-9512
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209-023883
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
016141
CT
363LG0600X
Gerontology Nurse Practitioner
209-023883
IL
Other
Enumeration date
08/26/2021
Last updated
03/25/2026
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