Provider Demographics
NPI:1427426444
Name:BUXHOEVEDEN, STEPHANIE KATE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:KATE
Last Name:BUXHOEVEDEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:KATE
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:220 EXECUTIVE CENTER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3395
Mailing Address - Country:US
Mailing Address - Phone:540-899-2900
Mailing Address - Fax:540-899-3395
Practice Address - Street 1:220 EXECUTIVE CENTER PARKWAY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3395
Practice Address - Country:US
Practice Address - Phone:540-899-2900
Practice Address - Fax:540-899-3395
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001225567163W00000X
VA0024173008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse