Provider Demographics
NPI:1336758846
Name:PRATHER, STEPHANIE ANN (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:PRATHER
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 BEVERLY WAY
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89460-6203
Mailing Address - Country:US
Mailing Address - Phone:775-232-2338
Mailing Address - Fax:
Practice Address - Street 1:1649 LUCERNE ST
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4369
Practice Address - Country:US
Practice Address - Phone:775-782-1603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV831694363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily