Provider Demographics
NPI:1720736119
Name:VOGEL, STEPHANIE DAWN (NP-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DAWN
Last Name:VOGEL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S KIRKWOOD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-7250
Mailing Address - Country:US
Mailing Address - Phone:314-543-5980
Mailing Address - Fax:
Practice Address - Street 1:1001 S KIRKWOOD RD STE 100
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-7250
Practice Address - Country:US
Practice Address - Phone:314-543-5980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2022005819363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health