Individual
STEPHANIE ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5683
(928) 855-8185
Mailing address
3580 YUCCA DR, LAKE HAVASU CITY, AZ 86404-2267
(336) 803-5754
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN214531
AZ
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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