Provider Demographics
NPI:1124746888
Name:CARTECIANO, STEPHANIE SURIO (FNP-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:SURIO
Last Name:CARTECIANO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 S SUNLAND WAY
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-5821
Mailing Address - Country:US
Mailing Address - Phone:415-215-6153
Mailing Address - Fax:
Practice Address - Street 1:432 S SUNLAND WAY
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-5821
Practice Address - Country:US
Practice Address - Phone:415-215-6153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10668598-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily