Provider Demographics
NPI:1972340768
Name:LEMMON, STEPHANIE NIKOLE (LDO)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:NIKOLE
Last Name:LEMMON
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:50739 VALLEY PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1751
Mailing Address - Country:US
Mailing Address - Phone:740-695-8418
Mailing Address - Fax:740-695-8424
Practice Address - Street 1:50739 VALLEY PLAZA DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1751
Practice Address - Country:US
Practice Address - Phone:740-695-8418
Practice Address - Fax:740-695-8424
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOP.017770-S156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician