1063485019 NPI number — CONNIE C STEHMAN CRNP

Table of content: CONNIE C STEHMAN CRNP (NPI 1063485019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063485019 NPI number — CONNIE C STEHMAN CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEHMAN
Provider First Name:
CONNIE
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CURTIS STEHMAN
Provider Other First Name:
CONSTANCE
Provider Other Middle Name:
EMILY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063485019
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 134
Provider Second Line Business Mailing Address:
134 FAIRVIEW AVE
Provider Business Mailing Address City Name:
BAUSMAN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17504-0134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-394-6488
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31 S LIME ST
Provider Second Line Business Practice Location Address:
PLANNED PARENTHOOD OF SUSQUEHANNA VALLEY
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-299-2891
Provider Business Practice Location Address Fax Number:
717-299-2004
Provider Enumeration Date:
02/09/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN236023L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 363L00000X , with the licence number: SP002044G , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)