Provider Demographics
NPI:1588352959
Name:FERRADO, STEFANIE TEMPLE (LPN)
Entity type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:TEMPLE
Last Name:FERRADO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 CONDUIT RD
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-2630
Mailing Address - Country:US
Mailing Address - Phone:609-781-1769
Mailing Address - Fax:
Practice Address - Street 1:3704 CONDUIT RD
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2630
Practice Address - Country:US
Practice Address - Phone:904-753-1632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002098057164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse