Provider Demographics
NPI:1548851918
Name:PFIESTER, STEPHANIE M (ARNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:PFIESTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 HOSPITAL DR NE
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32548-5015
Mailing Address - Country:US
Mailing Address - Phone:850-226-8857
Mailing Address - Fax:850-226-8859
Practice Address - Street 1:137 HOSPITAL DR NE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-5015
Practice Address - Country:US
Practice Address - Phone:850-226-8857
Practice Address - Fax:850-226-8859
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily