Provider Demographics
NPI:1528081791
Name:MARKOVICH-STEN, NADINE (PA-C)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:MARKOVICH-STEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 175
Mailing Address - Street 2:
Mailing Address - City:NORTHUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17857-0175
Mailing Address - Country:US
Mailing Address - Phone:570-988-0925
Mailing Address - Fax:570-988-6445
Practice Address - Street 1:550 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:SHAMOKIN
Practice Address - State:PA
Practice Address - Zip Code:17872-5226
Practice Address - Country:US
Practice Address - Phone:570-644-2222
Practice Address - Fax:570-648-4705
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA0010701363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant