Provider Demographics
NPI:1427639343
Name:ALSTON, STEPHANIE JOAN
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JOAN
Last Name:ALSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 SUNNYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1613
Mailing Address - Country:US
Mailing Address - Phone:304-610-0306
Mailing Address - Fax:
Practice Address - Street 1:777 PENN CENTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5928
Practice Address - Country:US
Practice Address - Phone:412-243-3400
Practice Address - Fax:412-829-8121
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA274098164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse