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Individual

STEPHANIE BORK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
834 WALNUT ST, SUITE 650, PHILADELPHIA, PA 19107-5109
(215) 955-5161
Mailing address
834 WALNUT ST, SUITE 650, PHILADELPHIA, PA 19107-5109

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP015699
PA
363LF0000X
Family Nurse Practitioner
26NJ00443900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103086772
PA
Enumeration date
06/10/2013
Last updated
04/22/2016
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