Individual
STEPHANIE J HERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
600 GRANT ST, GARY, IN 46402-6001
(219) 886-4000
Mailing address
512 W WRIGHTWOOD AVE APT 2B, CHICAGO, IL 60614-4930
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000045A
IN
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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