Basic Information
Provider Information
NPI: 1275961823
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STROBL
FirstName: STEPHANIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 101 HOSPITAL BLVD
Address2:  
City: JEFFERSONVILLE
State: IN
PostalCode: 471303769
CountryCode: US
TelephoneNumber: 8122823899
FaxNumber:  
Practice Location
Address1: 3920 S DUPONT SQ STE C
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402074615
CountryCode: US
TelephoneNumber: 8122823899
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/17/2013
LastUpdateDate: 09/25/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X3008333KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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