Provider Demographics
NPI:1487983482
Name:MANDELL, STEPHANIE MARIE (APRN)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MARIE
Last Name:MANDELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2623 CENTENNIAL BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-0601
Mailing Address - Country:US
Mailing Address - Phone:850-702-5007
Mailing Address - Fax:850-219-1059
Practice Address - Street 1:2623 CENTENNIAL BLVD STE 204
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-0601
Practice Address - Country:US
Practice Address - Phone:850-702-5007
Practice Address - Fax:850-219-1059
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL9338300363LF0000X
FLAPRN9338300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily