Provider Demographics
NPI:1114632643
Name:MCLAIN, STEPHANIE COOK (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:COOK
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 N CUTHBERT ST
Mailing Address - Street 2:
Mailing Address - City:COLQUITT
Mailing Address - State:GA
Mailing Address - Zip Code:39837-3518
Mailing Address - Country:US
Mailing Address - Phone:229-758-3385
Mailing Address - Fax:
Practice Address - Street 1:208 N CUTHBERT ST
Practice Address - Street 2:
Practice Address - City:COLQUITT
Practice Address - State:GA
Practice Address - Zip Code:39837-3517
Practice Address - Country:US
Practice Address - Phone:229-281-6096
Practice Address - Fax:229-281-6097
Is Sole Proprietor?:No
Enumeration Date:2023-01-19
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN230610363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner