Gladden, Stephanie Dawn

Gladden, Stephanie Dawn is an individual health care provider with primary practice located at 1000 Tavern Rd Ste 100 , Martinsburg WV 25401-2853. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gladden, Stephanie Dawn can be contacted via phone (304) 267-9355.

Contact Information

Primary practice address
1000 Tavern Rd Ste 100 Martinsburg WV 25401-2853
Fax: (304) 267-9358
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 53032 West Virginia

Profile Details

NPI number 1730119447
LBN Legal business name Gladden, Stephanie Dawn
Credentials APRN, BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Mar 8th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730119447 NPPES
West Virginia MEDICAID 3810001103

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