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Individual

MISS STEPHANIE W CONN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.C.

Contact information

Practice address
1627 EYE ST NW, SUITE 800, WASHINGTON, DC 20006-4007
(202) 660-0025
(202) 660-0015
Mailing address
130 SUTTER ST 2, SAN FRANCISCO, CA 94104-4009
(415) 658-6791
(415) 520-0904

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA 9105004
FL
363AM0700X
Medical Physician Assistant
Primary
PA030914
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA 9105004
STATE LICENSE
FL
Enumeration date
06/30/2009
Last updated
10/14/2016
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