Basic Information
Provider Information
NPI: 1013680982
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALSTEEN
FirstName: STEPHANIE
MiddleName: D.
NamePrefix: MRS.
NameSuffix:  
Credential: RN, MSN, AGACNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCHMILL
OtherFirstName: STEPHANIE
OtherMiddleName: D.
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 200 W ARBOR DR
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921039000
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 200 W ARBOR DR
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921039000
CountryCode: US
TelephoneNumber: 8009268273
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/27/2021
LastUpdateDate: 03/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/29/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X95017675CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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