Basic Information
| Provider Information | |||||||||
| NPI: | 1912346438 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOMOGIE | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 117 MOWRY RD | ||||||||
| Address2: | |||||||||
| City: | MONACA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150612223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7244953533 | ||||||||
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| Practice Location | |||||||||
| Address1: | 659 3RD ST | ||||||||
| Address2: | |||||||||
| City: | BEAVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150092115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247751118 | ||||||||
| FaxNumber: | 7247752375 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2013 | ||||||||
| LastUpdateDate: | 06/18/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | PN286627 | PA | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.