Herrick, Stephanie Louise

Herrick, Stephanie Louise is an individual health care provider with primary practice located at 1987 Mcculloch Blvd N Ste 101, Lake Havasu City AZ 86403-5682. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Herrick, Stephanie Louise can be contacted via phone (928) 453-6963.

Contact Information

Primary practice address
1987 Mcculloch Blvd N Ste 101 Lake Havasu City AZ 86403-5682
Phone: (928) 453-6963
Fax: (928) 453-7011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP328 Arizona

Profile Details

NPI number 1083702716
LBN Legal business name Herrick, Stephanie Louise
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Sep 10th, 2009 - about 17 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 1083702716 NPPES
Arizona MEDICAID 144767

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